血清表面活性蛋白D作为衡量2型糖尿病肥胖患者肺部受累情况的生物标志物。

Serum Surfactant Protein D as a Biomarker for Measuring Lung Involvement in Obese Patients With Type 2 Diabetes.

作者信息

López-Cano Carolina, Lecube Albert, García-Ramírez Marta, Muñoz Xavier, Sánchez Enric, Seminario Asunción, Hernández Marta, Ciudin Andreea, Gutiérrez Liliana, Hernández Cristina, Simó Rafael

机构信息

Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, 25198 Lleida, Catalonia, Spain.

Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28029 Madrid, Spain.

出版信息

J Clin Endocrinol Metab. 2017 Nov 1;102(11):4109-4116. doi: 10.1210/jc.2017-00913.

DOI:10.1210/jc.2017-00913

PMID:28945872

Abstract

CONTEXT

Lung impairment is a new target for late diabetic complications. Biomarkers that could help identify patients requiring functional respiratory tests have not been reported.

OBJECTIVE

Our aim was to examine whether serum surfactant protein D (SP-D) and A (SP-A) could be useful biomarkers of lung damage in obese patients with type 2 diabetes (T2D) without known lung disease.

DESIGN AND SETTING

A case-control study conducted in an ambulatory obesity unit.

PATIENTS

Forty-nine obese patients with T2D and 98 subjects without diabetes matched by age, sex, body mass index, and waist circumference were included.

INTERVENTIONS

Serum SP-D and SP-A levels were measured using enzyme-linked immunosorbent assay. Forced spirometry and static pulmonary volume were assessed.

RESULTS

Patients with T2D exhibited higher serum SP-D concentrations than control subjects (P = 0.006). No differences in serum SP-A concentrations were observed. There was an inverse association between forced expiratory volume in 1 second (FEV1) and serum SP-D (r = -0.265; P = 0.029), as well as a significant positive relationship between SP-D concentration and residual volume (r = 0.293; P = 0.043). From receiver operating characteristic analysis, the best SP-D cutoff to identify a FEV1 <80% of predicted was 132.3 ng/mL (area under the curve, 0.725; sensitivity, 77.7%; specificity, 69.4%). Stepwise multivariate regression analysis showed that serum SP-D concentration ≥132.3 ng/mL was independently associated with a FEV1 <80% of predicted (R2 = 0.406). Only the existence of T2D contributed independently to serum SD-P variance among all subjects (R2 = 0.138).

CONCLUSIONS

Serum SP-D concentration can be a useful biomarker for detecting lung impairment in obese patients with T2D.

摘要

背景

肺功能损害是糖尿病晚期并发症的一个新靶点。尚未有能帮助识别需要进行肺功能测试患者的生物标志物的相关报道。

目的

我们的目的是研究血清表面活性蛋白D（SP-D）和表面活性蛋白A（SP-A）是否可作为无已知肺部疾病的肥胖2型糖尿病（T2D）患者肺损伤的有用生物标志物。

设计与地点

在一个门诊肥胖科进行的病例对照研究。

患者

纳入了49例肥胖T2D患者和98例年龄、性别、体重指数和腰围相匹配的非糖尿病受试者。

干预措施

采用酶联免疫吸附测定法测量血清SP-D和SP-A水平。评估用力肺活量和静态肺容量。

结果

T2D患者的血清SP-D浓度高于对照组（P = 0.006）。未观察到血清SP-A浓度存在差异。一秒用力呼气量（FEV₁）与血清SP-D呈负相关（r = -0.265；P = 0.029），且SP-D浓度与残气量呈显著正相关（r = 0.293；P = 0.043）。通过受试者工作特征分析，识别FEV₁<预测值80%的最佳SP-D截断值为132.3 ng/mL（曲线下面积，0.725；敏感性，77.7%；特异性，69.4%）。逐步多元回归分析显示，血清SP-D浓度≥132.3 ng/mL与FEV₁<预测值80%独立相关（R² = 0.406）。在所有受试者中，仅T2D的存在独立影响血清SD-P的变化（R² = 0.138）。