Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Clin Chim Acta. 2022 Sep 1;534:161-166. doi: 10.1016/j.cca.2022.07.017. Epub 2022 Aug 1.
Type 2 diabetes mellitus (T2DM) is a well-established risk factor for cardiovascular diseases. We aimed to identify the biological variation of ten cardiovascular biochemical markers in T2DM patients to aid in their interpretation.
Blood samples for evaluating ten biomarkers were collected biweekly from 23 T2DM patients (10 men, 13 women) for three months. The analytical variability and variations of within-subject (CV) and between-subject (CV) levels were calculated, as well as the analytical performance specifications, reference change value (RCV), and index of individuality (II).
The levels of total cholesterol (CHOL), apolipoprotein A (apoA), homocysteine (HCY), high-sensitivity troponin T (hsTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) differed between males and females (P < 0.05). The CVs or CVs of the biomakers were higher than those of healthy participants in Westgard online database, except for hsTnT. Triglyceride (TG), lipoprotein (a) [Lp(a)] and NT-proBNP had relatively high CV, CV and RCV, whereas CHOL, high-density lipoprotein cholesterol (HDL-C), apoA and HCY showed low variation. Moreover, the II of HDL-C, LP(a), apoA, HCY and hsTnT was <0.6 and other biochemical markers was between 0.6 and 1.4.
The cardiovascular biochemical markers in T2DM patients showed higher CV or CV, except for hsTnT. ApoA had the lowest CV and CV values. Population-based reference intervals should be used with caution in clinical decision-making for T2DM patients.
2 型糖尿病（T2DM）是心血管疾病的一个明确的危险因素。我们旨在确定 T2DM 患者十种心血管生化标志物的生物学变异性，以帮助解释这些标志物。
从 23 名 T2DM 患者（10 名男性，13 名女性）中每两周采集一次评估十种生物标志物的血样，持续三个月。计算分析变异性和个体内（CV）和个体间（CV）水平的变异性，以及分析性能规格、参考变化值（RCV）和个体指数（II）。
总胆固醇（CHOL）、载脂蛋白 A（apoA）、同型半胱氨酸（HCY）、高敏肌钙蛋白 T（hsTnT）和 N 端脑钠肽前体（NT-proBNP）的水平在男性和女性之间存在差异（P<0.05）。除了 hsTnT 外，生物标志物的 CV 或 CV 高于 Westgard 在线数据库中健康参与者的 CV 或 CV。甘油三酯（TG）、脂蛋白（a）[Lp(a)]和 NT-proBNP 具有相对较高的 CV、CV 和 RCV，而 CHOL、高密度脂蛋白胆固醇（HDL-C）、apoA 和 HCY 显示出较低的变异性。此外，HDL-C、LP(a)、apoA、HCY 和 hsTnT 的 II 值<0.6，其他生化标志物的 II 值在 0.6 和 1.4 之间。
T2DM 患者的心血管生化标志物除了 hsTnT 外，CV 或 CV 较高。apoA 的 CV 和 CV 值最低。在临床决策中，应谨慎使用基于人群的参考区间来判断 T2DM 患者。
