Emergency Department, Beijing Hepingli Hospital.
Department of Neurology, Beijing Hepingli Hospital, Beijing, China.
Medicine (Baltimore). 2023 Nov 24;102(47):e36114. doi: 10.1097/MD.0000000000036114.
To investigate the risk factors for acute ischemic stroke (AIS) in patients with type 2 diabetes mellitus (T2DM) patients. a total of 120 T2DM patients who met the inclusion and exclusion criteria, from between January 2021 to June 2022, were randomly selected and divided into T2DM and T2DM + AIS groups based on the presence or absence of a history of AIS. Blood samples were collected by fasting, 24 hours after admission, and levels of serum uric acid (UA), serum homocysteine (Hcy), serum creatinine (SCR), blood urea nitrogen (BUN), fasting blood glucose (FBG), glycated hemoglobin A1c (HbA1c), serum total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein (hs-CRP), and lipoprotein-associated phospholipase A2 (Lp-PLA2) were measured. Multivariate logistic regression analysis was performed for the significantly associated indicators to analyze the risk factors for AIS, and finally ROC curve analysis was carried out to explore the predictive value of the above risk factors for AIS in T2DM patients. the levels of FBG, Hcy, Hs-CRP and Lp-PLA2 were significantly higher in the T2DM + AIS group than those in T2DM group (P < .05). Multivariate logistic regression analysis revealed that hs-CRP and Lp-PLA2 were independent risk factors for the development of AIS in patients with T2DM with an OR of 2.85 (95% CI: 1.26-6.43, P = .012) and 3.64 (95% CI: 1.63-8.12, P = .002), respectively. ROC curve analysis showed that plasma hs-CRP and Lp-PLA2 showed good performance to predict AIS occurrence in T2DM patients (AUC = 0.749, 95% CI: 0.663, 0.835; and 0.791, 95% CI: 0.712, 0.870), with a sensitivity of 58.1% and 83.9%, and a specificity of 84.5% and 60.3%, respectively. The optimal concentration cutoff points of hs-CRP and Lp-PLA2 were 3.38 mg/L and 204.2 ng/mL. our findings suggested that plasma hs-CRP and Lp-PLA2 were independent risk factors for developing AIS in T2DM patients. Hs-CRP and Lp-PLA2 are potential biomarker for risk for AIS in patients with T2DM.
探讨 2 型糖尿病（T2DM）患者发生急性缺血性脑卒中（AIS）的危险因素。
选取 2021 年 1 月至 2022 年 6 月符合纳入和排除标准的 120 例 T2DM 患者，根据是否有 AIS 病史分为 T2DM 组和 T2DM+AIS 组。入院后 24 小时空腹采集血样，检测血清尿酸（UA）、同型半胱氨酸（Hcy）、血清肌酐（SCR）、血尿素氮（BUN）、空腹血糖（FBG）、糖化血红蛋白 A1c（HbA1c）、总胆固醇（TC）、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、三酰甘油、高敏 C 反应蛋白（hs-CRP）和脂蛋白相关磷脂酶 A2（Lp-PLA2）水平。对差异有统计学意义的指标进行多因素 logistic 回归分析，探讨 AIS 的危险因素，并采用 ROC 曲线分析上述危险因素对 T2DM 患者 AIS 的预测价值。
T2DM+AIS 组 FBG、Hcy、hs-CRP 和 Lp-PLA2 水平均显著高于 T2DM 组（P<0.05）。多因素 logistic 回归分析显示，hs-CRP 和 Lp-PLA2 是 T2DM 患者发生 AIS 的独立危险因素，OR 值分别为 2.85（95%CI：1.26-6.43，P=0.012）和 3.64（95%CI：1.63-8.12，P=0.002）。ROC 曲线分析显示，血浆 hs-CRP 和 Lp-PLA2 对 T2DM 患者 AIS 发生具有良好的预测价值（AUC=0.749，95%CI：0.663，0.835；AUC=0.791，95%CI：0.712，0.870），其灵敏度分别为 58.1%和 83.9%，特异度分别为 84.5%和 60.3%，hs-CRP 和 Lp-PLA2 的最佳截断点分别为 3.38 mg/L 和 204.2 ng/mL。
血浆 hs-CRP 和 Lp-PLA2 是 T2DM 患者发生 AIS 的独立危险因素，hs-CRP 和 Lp-PLA2 可能是 T2DM 患者发生 AIS 的潜在生物标志物。
