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老年2型糖尿病患者血浆凝血因子VII、PAI-1及尿酸与胰岛素抵抗和大血管并发症的相关性分析

Analysis of the correlation between plasma coagulation factor VII, PAI-1, and uric acid with insulin resistance and macrovascular complications in elderly patients with type 2 diabetes.

作者信息

Li Lei, Shi Zhenfeng, Ma Lisha, Lu Yi

机构信息

Department of Endocrinology, Xingtai People's Hospital, Xingtai, China. Email:

Department of Endocrinology, Xingtai People's Hospital, Xingtai, China.

出版信息

Ann Palliat Med. 2021 Jan;10(1):664-671. doi: 10.21037/apm-20-2609.

Abstract

BACKGROUND

To analyze the correlations between plasma coagulation factor VII (FVII), plasma plasminogen activator inhibitor-1 (PAI-1), uric acid, and insulin resistance (IR) and diabetic macroangiopathy (DMAP) in elderly patients with type 2 diabetes mellitus (T2DM).

METHODS

The clinical data of 112 elderly T2DM patients admitted to our hospital between March 2017 and March 2020 were enrolled. Subgroups were allocated based on the inclusion and exclusion criteria, body mass index (BMI), homeostasis model assessment (HOMA)-IR and the presence of DMAP. The patients were allocated as the study objects (T2DM group, n=90), simple obesity (BMI ≥25 kg/m2, n=25), simple non-obese (BMI <25 kg/m2, n=22), obesity with DMAP (n=24), and non-obese with DMAP (n=19). Meanwhile, data from 50 healthy controls from physical examinations were employed. The levels of FVII, PAI-1, HOMA-IR and uric acid were determined. Pearson correlation analysis was used to measure the correlations, and the receiver operating characteristic (ROC) curve was used to determine the predictive value of detection indexes.

RESULTS

The levels of FVII, PAI-1, and uric acid in the T2DM group were higher than those of the control group (P<0.05). In terms of the levels of FVII, PAI-1, and uric acid: simple non-obese group < simple obese group < non-obese with DMAP group < obese with DMAP group (P<0.05). The levels of FVII, PAI-1, and uric acid in T2DM patients were positively correlated with BMI and Homeostasis model assessment (HOMA)-IR (P<0.05). The ROC curve results showed that the area under the curve (AUC) for FVII, PAI-1, and uric acid separately, as well as a combination of the three were 0.930, 0.831, 0.888, and 0.997, respectively.

CONCLUSIONS

FVII, PAI-1, and uric acid levels are elevated in elderly T2DM patients. The levels of FVII, PAI-1, and uric acid are closely related to IR in elderly T2DM patients. The combination of TFVII, PAI-1, and uric acid levels can be used as an effective measure to predict patients with DMAP. Furthermore, the levels of these markers should be promptly measured in a clinical setting for early intervention and improvement of the patient's outcomes.

摘要

背景

分析老年2型糖尿病(T2DM)患者血浆凝血因子VII(FVII)、血浆纤溶酶原激活物抑制剂-1(PAI-1)、尿酸与胰岛素抵抗(IR)及糖尿病大血管病变(DMAP)之间的相关性。

方法

纳入2017年3月至2020年3月我院收治的112例老年T2DM患者的临床资料。根据纳入和排除标准、体重指数(BMI)、稳态模型评估(HOMA)-IR及DMAP的存在情况进行亚组划分。将患者分为研究对象(T2DM组,n=90)、单纯肥胖(BMI≥25kg/m²,n=25)、单纯非肥胖(BMI<25kg/m²,n=22)、肥胖合并DMAP(n=24)及非肥胖合并DMAP(n=19)。同时,采用50例体检健康对照者的数据。测定FVII、PAI-1、HOMA-IR及尿酸水平。采用Pearson相关分析来衡量相关性,并使用受试者工作特征(ROC)曲线来确定检测指标的预测价值。

结果

T2DM组FVII、PAI-1及尿酸水平高于对照组(P<0.05)。就FVII、PAI-1及尿酸水平而言:单纯非肥胖组<单纯肥胖组<非肥胖合并DMAP组<肥胖合并DMAP组(P<0.05)。T2DM患者的FVII、PAI-1及尿酸水平与BMI和稳态模型评估(HOMA)-IR呈正相关(P<0.05)。ROC曲线结果显示,FVII、PAI-1及尿酸单独及三者联合的曲线下面积(AUC)分别为0.930、0.831、0.888及0.997。

结论

老年T2DM患者FVII、PAI-1及尿酸水平升高。老年T2DM患者FVII、PAI-1及尿酸水平与IR密切相关。FVII、PAI-1及尿酸水平联合可作为预测DMAP患者的有效措施。此外,应在临床环境中及时检测这些标志物的水平,以便早期干预并改善患者预后。

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