Ultrasound Department, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Ultrasound Department, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
J Clin Lab Anal. 2023 May;37(9-10):e24935. doi: 10.1002/jcla.24935. Epub 2023 Jun 23.
To investigate the correlation between brachial artery flow-mediated endothelium-dependent dilation (FMD) and platelet-lymphocyte ratio (PLR) in peripheral blood and coronary atherosclerosis in diabetic patients.
Seventy-five diabetic patients aged 62 ± 9 years, 68% male and 32% female, who underwent brachial artery endothelial function test and coronary CT scan were collected. Coronary artery calcification (CAC) was observed to assess the presence of coronary atherosclerosis, and high-resolution extravascular ultrasound was used to detect FMD. Platelet count and lymphocyte count were recorded by routine blood tests, and PLR was calculated for each study subject. Statistical methods were used to verify the association of FMD and PLR with CAC assessed by CT, respectively.
Patients with coronary atherosclerosis had decreased FMD and increased PLR compared with patients with normal coronary arteries. Univariate logistic regression analysis showed that CAC score was significantly associated with both FMD (odds ratio: 0.167; 95% confidence interval: 0.049-0.565; p = 0.002) and PLR (odds ratio: 0.127; 95% confidence interval: 0.033-0.484; p = 0.001) at FMD < 5.1% or PLR > 130. The area under the ROC curve of FMD and PLR alone was 0.760 and 0.763, respectively. In addition, combined diagnosis of FMD and PLR showed the highest area under the ROC curve (0.830).
FMD combined with PLR is expected to be a precise diagnostic modality for coronary artery calcification in diabetic patients.
研究外周血肱动脉血流介导的内皮依赖性舒张(FMD)和血小板-淋巴细胞比值(PLR)与糖尿病患者冠状动脉粥样硬化的相关性。
共纳入 75 例年龄 62±9 岁的糖尿病患者,其中男性 68%,女性 32%,均接受肱动脉内皮功能检测和冠状动脉 CT 扫描。观察冠状动脉钙化(CAC)以评估是否存在冠状动脉粥样硬化,并采用高分辨率血管外超声检测 FMD。常规血液检查记录血小板计数和淋巴细胞计数,并计算每位研究对象的 PLR。采用统计学方法分别验证 FMD 和 PLR 与 CT 评估的 CAC 之间的相关性。
与冠状动脉正常的患者相比,有冠状动脉粥样硬化的患者 FMD 降低,PLR 升高。单因素 logistic 回归分析显示,CAC 评分与 FMD(比值比:0.167;95%置信区间:0.049-0.565;p=0.002)和 PLR(比值比:0.127;95%置信区间:0.033-0.484;p=0.001)均显著相关,FMD<5.1%或 PLR>130。FMD 和 PLR 单独的 ROC 曲线下面积分别为 0.760 和 0.763。此外,FMD 和 PLR 联合诊断的 ROC 曲线下面积最高(0.830)。
FMD 联合 PLR 有望成为糖尿病患者冠状动脉钙化的精确诊断方法。