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2型糖尿病患者血浆纤维蛋白原水平测量的重要性。

The importance of measurement of plasma fibrinogen level among patients with type- 2 diabetes mellitus.

作者信息

Abdul Razak Manal Khudder, Sultan Ali Adnan

机构信息

University of Baghdad, Baghdad College of Medicine, Department of Medicine, Baghdad, Iraq.

Department of Medicine, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq.

出版信息

Diabetes Metab Syndr. 2019 Mar-Apr;13(2):1151-1158. doi: 10.1016/j.dsx.2019.01.049. Epub 2019 Jan 24.

Abstract

BACKGROUND & AIM: Fibrinogen has been implicated as a cause of atherosclerosis and its complications in patients with type 2 DM. We aimed to measure the plasma fibrinogen level in type 2 diabetics and to correlate it with the duration, type of treatment, HbA1c, smoking, lipid profile, diabetic retinopathy, hypertension and ischemic heart disease in comparison to control.

METHODS

A case control single center study included 50 patients with type 2 DM between the ages of 35-85 y who were randomly selected from the medical units of Baghdad Teaching Hospital compared to 30 non-diabetics as a control. After taking verbal consents; plasma fibrinogen levels were estimated and correlated with aimed variables. Odds ratios with 95% CI were calculated and regression analysis was performed for correlations. P ≤ 0.05 was considered statistically significant.

RESULTS

There were statistically significant differences regarding total cholesterol, TG, and LDL between cases and control. Mean HbA1c of diabetics was 8.31 ± 1.75% (P < 0.001). Cases showed plasma fibrinogen of (4.01 ± 1.89 g/dL) compared to (2.79 ± 0.55 g/dL) of control (P < 0.001). ROC curve revealed that the AUC was (0.679 ± 0.06, 95%CI = 0.561-0.797, P < 0.008). The sensitivity and specificity of the test at cut off value of 3.05 g/dL were 0.62 and 0.567 respectively. There was a significant correlation between fibrinogen level and each of HbA1c (r = 0.497, P < 0.001) and TG (r = 0.359, P = 0.01).

CONCLUSIONS

HbA1c has a significant positive effect on plasma fibrinogen and it is important to measure plasma fibrinogen level in patients with type 2 DM.

摘要

背景与目的

纤维蛋白原被认为是2型糖尿病患者动脉粥样硬化及其并发症的一个病因。我们旨在测量2型糖尿病患者的血浆纤维蛋白原水平,并将其与病程、治疗类型、糖化血红蛋白(HbA1c)、吸烟、血脂谱、糖尿病视网膜病变、高血压和缺血性心脏病进行相关性分析,同时与对照组进行比较。

方法

一项病例对照单中心研究纳入了50例年龄在35 - 85岁之间的2型糖尿病患者,这些患者是从巴格达教学医院的各个医疗科室中随机选取的,另外选取30例非糖尿病患者作为对照。在获得口头同意后,测定血浆纤维蛋白原水平,并与目标变量进行相关性分析。计算95%置信区间的比值比,并进行相关性的回归分析。P≤0.05被认为具有统计学意义。

结果

病例组与对照组在总胆固醇、甘油三酯(TG)和低密度脂蛋白(LDL)方面存在统计学显著差异。糖尿病患者的平均糖化血红蛋白为8.31±1.75%(P<0.001)。病例组的血浆纤维蛋白原为(4.01±1.89g/dL),而对照组为(2.79±0.55g/dL)(P<0.001)。ROC曲线显示曲线下面积(AUC)为(0.679±0.06,95%置信区间 = 0.561 - 0.797,P<0.008)。在截断值为3.05g/dL时,该检测的敏感性和特异性分别为0.62和0.567。纤维蛋白原水平与糖化血红蛋白(r = 0.497,P<0.001)和甘油三酯(r = 0.359,P = 0.01)均存在显著相关性。

结论

糖化血红蛋白对血浆纤维蛋白原有显著的正向影响,对于2型糖尿病患者而言,测量血浆纤维蛋白原水平很重要。

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