Feng Fen, Chen Yong, Wang Gang, Huang Ping, Zhu Qiaolin, Zhou Bin
School of Pharmacy, Shaoyang University, Shaoyang, China.
Department of Oncology and Hematology, The Central Hospital of Shaoyang, Shaoyang, China.
Front Surg. 2022 Mar 9;9:846470. doi: 10.3389/fsurg.2022.846470. eCollection 2022.
To investigate the serum level of cystatin C (CysC), ischemia-modified albumin (IMA), and lipoprotein-associated phospholipase A2 (LP-PLA2) in patients with type 2 diabetes mellitus (T2DM) and with lower extremity atherosclerotic occlusive disease (LEASOD) and their correlation.
From March 2017 to December 2019, 110 patients with T2DM with LEASOD, who were treated in our hospital, were selected as the observation group. One hundred ten healthy persons who received medical examination in our hospital during the same period were selected as the control group. Serum CysC, IMA, LP-PLA2, and ankle-brachial index (ABI) were detected in each group. According to the ABI index, the observation group was divided into three subgroups, namely, the mild group ( = 45), the moderate group ( = 42), and the severe group ( = 23). Pearson correlation analysis was used to analyze the relationship between serum CysC, IMA, and LP-PLA2 levels in patients with T2DM with LEASOD and their condition. The receiver operator characteristic (ROC) curve was used to analyze the diagnostic value of serum CysC, IMA, and LP-PLA2 levels in patients with T2DM with LEASOD.
The serum levels of CysC, IMA, and LP-PLA2 in the observation group were higher than those in the control group ( < 0.05). The serum levels of CysC, IMA, and LP-PLA2 in the severe and the moderate group were higher than those in the mild group, and the serum levels of CysC, IMA, and LP-PLA2 in the severe group were higher than those in the moderate group ( < 0.05). Pearson correlation analysis showed that CysC, IMA, and LP-PLA2 levels were all negatively correlated with ABI (r = -0.802, r = -0.757, r = -0.764, < 0.001). The ROC curve results showed that the area under the curve (AUC) of serum CysC in the diagnosis of T2DM with LEASOD was 0.806, and the best cut-off value was 1.74 mg/L. The AUC of serum IMA for diagnosis of T2DM with LEASOD was 0.772, and the best cut-off value was 92.58 g/L. The AUC of serum LP-PLA2 in the diagnosis of T2DM with LEASOD was 0.781, and the best cut-off value was 544.86 ng/L. The AUC of the three combined diagnoses of T2DM with LEASOD was 0.863.
Serum levels of CysC, IMA, and LP-PLA2 were increased in patients with T2DM with LEASOD. Serum CysC, IMA, and LP-PLA2 are closely related to the severity of the disease. The higher the serum levels of CysC, IMA, and LP-PLA2, the more serious the degree of lower extremity arteriosclerosis occlusion, which can be used as an important serum marker to monitor the severity of T2DM with LEASOD. The combined detection of serum CysC, IMA, and LP-PLA2 has good diagnostic value for patients with T2DM with LEASOD.
探讨2型糖尿病（T2DM）合并下肢动脉硬化闭塞症（LEASOD）患者血清胱抑素C（CysC）、缺血修饰白蛋白（IMA）和脂蛋白相关磷脂酶A2（LP-PLA2）水平及其相关性。
选取2017年3月至2019年12月在我院接受治疗的110例T2DM合并LEASOD患者作为观察组。选取同期在我院进行体检的110例健康人作为对照组。检测两组血清CysC、IMA、LP-PLA2及踝肱指数（ABI）。根据ABI指数，将观察组分为三个亚组，即轻度组（=45）、中度组（=42）和重度组（=23）。采用Pearson相关分析探讨T2DM合并LEASOD患者血清CysC、IMA和LP-PLA2水平与病情的关系。采用受试者工作特征（ROC）曲线分析血清CysC、IMA和LP-PLA2水平对T2DM合并LEASOD患者的诊断价值。
观察组血清CysC、IMA和LP-PLA2水平高于对照组（<0.05）。重度组和中度组血清CysC、IMA和LP-PLA2水平高于轻度组，重度组血清CysC、IMA和LP-PLA2水平高于中度组（<0.05）。Pearson相关分析显示，CysC、IMA和LP-PLA2水平均与ABI呈负相关（r=-0.802，r=-0.757，r=-0.764，<0.001）。ROC曲线结果显示，血清CysC诊断T2DM合并LEASOD的曲线下面积（AUC）为0.806，最佳截断值为1.74mg/L。血清IMA诊断T2DM合并LEASOD的AUC为0.772，最佳截断值为92.58g/L。血清LP-PLA2诊断T2DM合并LEASOD的AUC为0.781，最佳截断值为544.86ng/L。三项联合诊断T2DM合并LEASOD的AUC为0.863。
T2DM合并LEASOD患者血清CysC、IMA和LP-PLA2水平升高。血清CysC、IMA和LP-PLA2与疾病严重程度密切相关。血清CysC、IMA和LP-PLA2水平越高，下肢动脉硬化闭塞程度越严重，可作为监测T2DM合并LEASOD严重程度的重要血清标志物。血清CysC、IMA和LP-PLA2联合检测对T2DM合并LEASOD患者具有良好的诊断价值。
