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Received:November 13, 2018 Published Online:March 20, 2019
Received:November 13, 2018 Published Online:March 20, 2019
中文摘要: 目的 探索半乳糖凝集素3(galectin-3,Gal-3)在2型糖尿病合并脑梗死患者血清中的水平及其临床意义。方法 采用回顾性病例对比方法,选取2018年1月至10月期间住院的2型糖尿病合并脑梗死患者、脑梗死患者、2型糖尿病患者及同时期的健康体检者各30例,比较各组受检者的实验室指标及血清Gal-3水平,采用Spearman相关分析Gal-3的相关因素,采用二元线性回归分析2型糖尿病合并脑梗死的影响因素,采用受试者工作特征曲线(ROC)评估血清Gal-3预测脑梗死的效能。结果 2型糖尿病合并脑梗死组患者血清Gal-3水平［9.93(7.04,14.39)ng/ml］高于脑梗死组［6.00(5.28,6.68)ng/ml］、2型糖尿病组［6.01(4.97,7.10)ng/ml］及健康对照组［1.80(1.58,2.55)ng/ml］,脑梗死组和2型糖尿病组高于健康对照组,差异均有统计学意义(P<0.05)。Spearman相关分析显示糖尿病病程、高敏C反应蛋白(hs-CRP)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、同型半胱氨酸(Hcy)均与Gal-3呈正相关(r=0.483,0.324,0.427,0.475,0.324,P<0.05),高密度脂蛋白(HDL)与Gal-3呈负相关(r=-0.286,P<0.05)。二元线性回归分析显示hs-CRP、Hcy和Gal-3均为2型糖尿病合并脑梗死的危险因素(OR=1.364,1.332,1.712,P<0.05或P<0.01)。ROC分析显示,当血清Gal-3=8.48 ng/ml时,其对糖尿病并发脑梗死具有良好的预测效能(AUC=0.826,P=0.000)。结论 血清Gal-3水平在2型糖尿病合并脑梗死患者中升高,是糖尿病合并脑梗死患者的独立危险因素,并可作为2型糖尿病患者并发脑梗死的临床生物学指标。
Abstract:Objective To investigate serum galectin-3 level in patients with type 2 diabetes (T2DM) complicated with cerebral infarction and its significance. Methods Using a retrospective case-control study, 30 cases of T2DM complicated with cerebral infarction, 30 cases of cerebral infarction, 30 cases of T2DM hospitalized from January to October 2018 and 30 healthy subjects in the same period were selected. The relative laboratory indexes and serum galectin 3 levels in subjects of each group were compared. Spearman correlation analysis was used to confirm the related factors influencing galectin-3 level. Binary linear regression analysis was used to confirm the influencing factors of T2DM complicated with cerebral infarction. Receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of serum galectin-3 for predicting cerebral infarction. Results The level of galectin-3 in patients with T2DM complicated with cerebral infarction ［9.93 (7.04, 14.39) ng/ml］ was higher than those in patients with cerebral infarction ［6.00 (5.28, 6.68) ng/ml］, T2DM patients ［6.01 (4.97, 7.10) ng/ml］ and healthy subjects ［1.80 (1.58, 2.55) ng/ml］, and the levels of galectin-3 in cerebral infarction patients and T2DM patients were higher than that of healthy subjects (P<0.05).Spearman correlation analysis showed that the course of diabetes mellitus, hypersensitive C-reactive protein (hs-CRP) , fasting blood glucose (FBG) , glycosylated hemoglobin A1c (HbA1c) and homocysteine (Hcy) were positively correlated with galectin-3 (r=0.483, 0.324, 0.427, 0.475, 0.324, P<0.05).High density lipoprotein (HDL) was negatively correlated with galectin-3 (r=-0.286, P<0.05). Binary linear regression analysis showed that hs-CRP, Hcy and galectin-3 were the risk factors of T2DM complicated with cerebral infarction (OR=1.364, 1.332, 1.712, P<0.05 or P<0.01). ROC analysis showed that when the best cut-off value of galectin-3 was 8.48 ng/ml, its AUC was 0.826 (P=0.000) , which had a good predictive effect on diabetes mellitus complicated with cerebral infarction. Conclusion Serum galectin-3 level is elevated in patients with T2DM complicated with cerebral infarction. Galectin-3 is an independent risk factor of patients with T2DM complicated with cerebral infarction and can be used as a clinical biological indicator for the patients with T2DM complicated with cerebral infarction.
keywords: Type 2 diabetes mellitus Cerebral infarction Galectin-3 Receiver operating characteristic curve
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