[1]李博,刘明远,李幸,等.血清Irisin、PTX3及MALAT1水平与糖尿病视网膜病变病情程度的关系及联合诊断价值[J].眼科新进展,2024,44(6):470-475.[doi:10.13389/j.cnki.rao.2024.0091]
 LI Bo,LIU Mingyuan,LI Xing,et al.Correlation between serum Irisin, pentraxin 3, metastasis-associated lung adenocarcinoma transcript 1 levels and the severity of diabetic retinopathy and the value of combined diagnosis[J].Recent Advances in Ophthalmology,2024,44(6):470-475.[doi:10.13389/j.cnki.rao.2024.0091]
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血清Irisin、PTX3及MALAT1水平与糖尿病视网膜病变病情程度的关系及联合诊断价值/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
44卷
期数:
2024年6期
页码:
470-475
栏目:
应用研究
出版日期:
2024-06-03

文章信息/Info

Title:
Correlation between serum Irisin, pentraxin 3, metastasis-associated lung adenocarcinoma transcript 1 levels and the severity of diabetic retinopathy and the value of combined diagnosis
作者:
李博刘明远李幸张新桥曹婷婷王曦李朝霞柏玲
061017 河北省沧州市,沧州市中心医院眼一科(李博,李幸,张新桥,曹婷婷,李朝霞);061017 河北省沧州市,沧州市中心医院麻醉一科(刘明远);061017 河北省沧州市,沧州市中心医院呼吸与危重症医学二科(王曦);421009 湖南省衡阳市,南华大学附属第一医院眼科(柏玲)
Author(s):
LI Bo1LIU Mingyuan2LI Xing1ZHANG Xinqiao1CAO Tingting1WANG Xi3LI Zhaoxia1BAI Ling4
1.Ophthalmology Department 1 of Cangzhou Central Hospital,Cangzhou 061017,Hebei Province,China
2.Anesthesia Department 1 of Cangzhou Central Hospital,Cangzhou 061017,Hebei Province,China
3.Respiratory and Critical Care Medicine Department 2,Cangzhou Central Hospital,Cangzhou 061017,Hebei Province,China
4.Ophthalmology Department of the First Affiliated Hospital of South China University,Hengyang 421009,Hunan Province,China
关键词:
IrisinPTX3MALAT1糖尿病视网膜病变病情程度诊断价值
Keywords:
irisin pentraxin 3 metastasis-associated lung adenocarcinoma transcript 1 diabetic retinopathy disease severity diagnostic value
分类号:
R774
DOI:
10.13389/j.cnki.rao.2024.0091
文献标志码:
A
摘要:
目的 研究血清鸢尾素(Irisin)、长正五聚蛋白3(PTX3)、人肺腺癌转移相关转录本1(MALAT1)水平与糖尿病视网膜病变(DR)病情程度的关系及联合诊断的价值。
方法 选取2022年4月至2023年4月沧州市中心医院2型糖尿病(T2DM)合并DR患者85例设为DR组,85例单纯T2DM患者设为非DR组,同时期85例健康志愿者设为对照组。将DR组患者以是否处于增生型DR为标准分为增生型组(38例)与非增生型组(47例)。收集DR组患者病例临床资料,包括性别、舒张压、年龄、收缩压、病程、空腹血糖(FPG)、体质量指数、糖化血红蛋白(HbA1c)、吸烟史、甘油三酯(TG)、饮酒史、收缩期峰值流速、舒张末期峰值流速、阻力指数、空腹胰岛素(FINS)、糖尿病家族史、总胆固醇(TC)、胰岛素抵抗指数(HOMA-IR)。酶联免疫吸附法检测各组患者血清Irisin、PTX3水平,实时荧光定量PCR法检测血清MALAT1水平。采用Pearson相关性分析检测血清Irisin、PTX3及MALAT1水平与DR患者病情程度的相关性。Logistic回归分析DR患者病情程度的影响因素。受者工作特征曲线(ROC曲线)分析血清Irisin、PTX3及MALAT1单独诊断DR的价值。ROC曲线、净重新分类指数(NRI)及综合判别改善指数(IDI)分析含与不含血清Irisin、PTX3及MALAT1方案诊断DR的价值。
结果 3组患者血清Irisin、PTX3、MALAT1水平比较,差异均有统计学意义(均为P<0.001)。增生型组患者病程长于非增生型组,收缩期峰值流速、舒张末期峰值流速、血清Irisin水平均低于非增生型组,阻力指数、FPG、HbA1c、TG、FINS、HOMA-IR及血清PTX3、MALAT1水平均高于非增生型组,差异均有统计学意义(均为P<0.05)。DR患者血清Irisin水平与DR病情程度呈负相关(r=-0.512,P<0.001),PTX3、MALAT1水平与DR病情程度均呈正相关(r=0.497、0.573,均为P<0.05)。Logistic回归分析结果显示,病程、FPG、HbA1c、TG、FINS、HOMA-IR、收缩期峰值流速、舒张末期峰值流速、阻力指数及血清Irisin、PTX3、MALAT1水平均为DR病情程度加重的影响因素(均为P<0.05)。血清Irisin、PTX3、MALAT1诊断DR的曲线下面积(AUC)分别为0.743、0.811、0.773。与常规诊断方案比较,含有血清Irisin、PTX3、MALAT1水平的新诊断方案的AUC明显增大(Z=2.708,P=0.007),NRI、IDI分别为0.039(95%CI:0.022~0.069)、0.026(95%CI:0.014~0.047)(均为P<0.05)。
结论 DR患者血清Irisin水平降低,PTX3、MALAT1水平升高,且与患者DR病情程度密切相关,含有血清Irisin、PTX3、MALAT1指标的诊断方案具有较高的诊断价值。
Abstract:
Objective To investigate the correlation between serum Irisin, long pentraxin 3 (PTX3), human metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) levels and the severity of diabetic retinopathy (DR) and the value of combined diagnosis.
Methods Eighty-five patients with type 2 diabetes mellitus (T2DM) combined with DR at Cangzhou Central Hospital from April 2022 to April 2023 were selected as the DR group, 85 patients with T2DM alone were selected as the non-DR group, and 85 healthy volunteers were selected as the control group during the same period. Patients in the DR group were further divided into the proliferative DR (PDR) group (38 patients) and the non-PDR group (47 patients) based on whether DR was in the proliferative phase. Clinical data of patients in the DR group were collected, including gender, diastolic pressure, age, systolic pressure, disease course, fasting plasma glucose (FPG), body mass index, hemoglobin A1c (HbA1c), smoking history, triglyceride (TG), drinking history, peak systolic velocity (PSV), peak end-diastolic velocity (PEDV), resistance index (RI), fasting insulin (FINS), family history of diabetes, total cholesterol (TC), and homa-insulin resistance (HOMA-IR). Enzyme-linked immunosorbent assay was used to detect serum levels of Irisin and PTX3 in each group of patients, and real-time quantitative polymerase chain reaction was used to detect the serum level of MALAT1. The correlations between serum levels of Irisin, PTX3 and MALAT1 and the severity of DR were analyzed using the Pearson correlation coefficient. The influencing factors of the DR severity were identified using the Logistic regression. The value of serum Irisin, PTX3, and MALAT1 levels in diagnosing DR alone was analyzed using the receiver operating characteristic (ROC) curve. The value of regimens containing and not containing serum Irisin, PTX3, and MALAT1 levels in diagnosing DR was analyzed using the ROC curve, net reclassification index (NRI), and integrated discrimination improvement (IDI) index.
Results The serum levels of Irisin, PTX3, and MALAT1 were compared among the three groups of patients, and the differences were statistically significant (all P<0.001). The disease course of patients in the PDR group was longer than that in the non-PDR group, the PSV, PEDV and serum Irisin level were lower than those in the non-PDR group, while the RI, FPG, HbA1c, TG, FINS, HOMA-IR, and serum PTX3 and MALAT1 levels were higher than those in the non-PDR group (all P<0.05). The serum Irisin level in DR patients was negatively correlated with the severity of DR (r=-0.512, P<0.001), while the PTX3 and MALAT1 levels were positively correlated with the severity of DR (r=0.497, 0.573, both P<0.05). The Logistic regression analysis showed that the disease course, FPG, HbA1c, TG, FINS, HOMA-IR, PSV, PEDV, RI, and serum levels of Irisin, PTX3 and MALAT1 were influencing factors for the DR progression (all P<0.05). The area under the curve (AUC) of serum Irisin, PTX3, and MALAT1 levels in diagnosing DR was 0.743, 0.811, and 0.773, respectively. Compared with conventional diagnostic protocols, the AUC of the new diagnostic protocol containing serum levels of Irisin, PTX3, and MALAT1 significantly increased (Z=2.708, P=0.007), and the NRI and IDI were 0.039 (95%CI: 0.022-0.069) and 0.026 (95%CI: 0.014-0.047), respectively (all P<0.05).
Conclusion The serum Irisin level in DR patients decreases, while the serum PTX3 and MALAT1 levels increase, which are closely related to the severity of DR. Diagnostic plans containing serum Irisin, PTX3, and MALAT1 indicators have high diagnostic value.

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备注/Memo

备注/Memo:
沧州市重点研发计划指导项目(编号:222106098)
更新日期/Last Update: 2024-06-05