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2 型糖尿病合并冠心病男性患者循环成纤维细胞生长因子 21 与总睾酮水平变化

Circulating Fibroblast Growth Factor 21 and Total Testosterone in Type 2 Diabetes Mellitus Men With Coronary Heart Disease.

机构信息

Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.

出版信息

Front Endocrinol (Lausanne). 2022 Jul 15;13:912243. doi: 10.3389/fendo.2022.912243. eCollection 2022.

Abstract

BACKGROUND

Fibroblast growth factor 21 increased in population with type 2 diabetes mellitus (T2DM), while serum total testosterone often decreased in men with T2DM. This study aimed to investigate the relationship between the prevalence of coronary artery disease (CAD) and circulating FGF21 concentrations and serum testosterone in T2DM men.

METHODS

490 men with T2DM from January 2021 to December 2021 were recruited from the Renmin Hospital of Wuhan University, and they were divided into CAD group (n=248) and control group (n=242). FGF21 were determined based on ELISA principle and serum total testosterone was measured in a liquid chromatography mass spectrometer LC/MS-8050 (Shimadzu, Japan). Logistic and restricted cubic spline analyses were performed to examine the association between the prevalence of CAD and circulating FGF21 concentrations and serum testosterone in T2DM men. The receiver operating curve (ROC) analysis was used to explore the predictive performance.

RESULTS

Circulating FGF21 levels were higher in T2DM men with CAD compared with those without CAD [214.63 (121.82, 348.64) pg/ml vs 166.55 (94.81,254.48) pg/ml, <0.001], while serum total testosterone was lower [3.08 ± 0.07 ng/ml vs 3.76 ± 0.09 ng/ml, p<0.001]. The fully adjusted odds ratio (OR) and 95% confidence intervals (95%CI) was 2.956(1.409,6.201) for those in quartile 4 of FGF21 versus quartile 1 and the fully adjusted OR (95%CI) was 0.346(0.174,0.686) for those in quartile 4 of testosterone versus quartile 1. The receiver operating curve (ROC) analysis showed that the area under the curve (AUC) of combination of FGF21 and testosterone for predicting the occurrence of CAD in men with T2DM was 0.702 (95% CI: 0.667-0.741).

CONCLUSION

Circulating FGF21 levels were positively associated with CAD in men with T2DM, whereas serum total testosterone levels showed an inverse correlation with CAD in diabetic men.

摘要

背景

2 型糖尿病(T2DM)患者的成纤维细胞生长因子 21(FGF21)水平升高,而血清总睾酮(testosterone)水平在 T2DM 男性中往往降低。本研究旨在探讨 T2DM 男性中循环 FGF21 浓度和血清睾酮与冠状动脉疾病(CAD)患病率之间的关系。

方法

2021 年 1 月至 12 月,从武汉大学人民医院招募了 490 名 T2DM 男性,他们被分为 CAD 组(n=248)和对照组(n=242)。基于 ELISA 原理测定 FGF21,采用液相色谱质谱联用仪 LC/MS-8050(岛津,日本)测定血清总睾酮。采用 logistic 和限制立方样条分析探讨 T2DM 男性中 CAD 患病率与循环 FGF21 浓度和血清睾酮之间的关系。采用受试者工作特征曲线(ROC)分析评估预测性能。

结果

与无 CAD 的 T2DM 男性相比,CAD 男性的循环 FGF21 水平更高[214.63(121.82,348.64)pg/ml 比 166.55(94.81,254.48)pg/ml,<0.001],而血清总睾酮水平更低[3.08±0.07ng/ml 比 3.76±0.09ng/ml,p<0.001]。FGF21 四分位 4 与四分位 1 相比,完全调整后的比值比(OR)和 95%置信区间(95%CI)为 2.956(1.409,6.201);与四分位 1 相比,睾酮四分位 4 的完全调整后 OR(95%CI)为 0.346(0.174,0.686)。ROC 分析显示,FGF21 和睾酮联合预测 T2DM 男性 CAD 发生的曲线下面积(AUC)为 0.702(95%CI:0.667-0.741)。

结论

在 T2DM 男性中,循环 FGF21 水平与 CAD 呈正相关,而血清总睾酮水平与糖尿病男性的 CAD 呈负相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdda/9334747/ec1307d8e328/fendo-13-912243-g001.jpg

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