2型糖尿病患者颈动脉粥样硬化程度与血清ADAM10水平的相关性

目的探讨2型糖尿病(T2DM)患者血清解整合素-金属蛋白酶10(ADAM10)水平与颈动脉粥样硬化分级的相关性,并探究T2DM并发动脉粥样硬化的危险因素。方法采用回顾性研究方法,选取昆明医科大学第一附属医院2017年9月至2018年6月收治的T2DM患者87例,根据颈部血管彩超检查结果分为3组,即无动脉粥样硬化组(n=25)、动脉内-中膜厚度(IMT)增厚组(n=14)、粥样斑块形成组(n=48),比较各组间血清ADAM10水平,采用Logistic回归分析动脉粥样硬化危险因素;根据颈部血管情况分为无动脉粥样硬化组(n=25)及动脉粥样硬化组(n=62),使用受试者工作特征曲线(ROC)分析血清ADAM10水平的诊断价值。结果依颈动脉粥样硬化程度进展(无动脉粥样硬化组→动脉IMT增厚组→粥样斑块形成组),血清ADAM10水平有递升趋势(1676.12±736.42)pg/ml→(1835.00±798.79)pg/ml→(2016.77±787.63)pg/ml,但差异无统计学意义(P>0.05)。Logistic回归分析显示,糖尿病病程延长、增龄、收缩压升高、血清ADAM10水平增加是T2DM患者动脉粥样硬化加重的危险因素。血清ADAM10水平预测T2DM并发颈动脉粥样硬化的ROC曲线下面积(AUC)为0.612(95%CI:0.480,0.743),最佳截断值为1426.50 pg/ml,灵敏度为0.82,特异度为0.44。结论糖尿病病程延长、增龄、收缩压升高、血清ADAM10水平升高是T2DM颈动脉粥样硬化加重的危险因素。血清ADAM10升高对T2DM并发颈动脉粥样硬化可能具有警示作用。

Relationship between carotid atherosclerosis and serum ADAM10 level in patients with type 2 diabetes mellitus

Objective To investigate the correlation between serum a disintegrin and metalloproteinase(ADAM10)level and grade of carotid atherosclerosis(AS)in patients with type 2 diabetes mellitus(T2 DM)and explore the risk factors of T2 DM complicated with AS.Methods Eighty-seven patients with T2 DM were recruited from the First Affiliated Hospital of Kunming Medical University between September 2017 and June 2018.According to the results of carotid vascular color Doppler ultrasound,they were divided into non-atherosclersis group(n=25),arterial intima-media thickness(IMT)thickening group(IMT thickening group,n=14)and atherogenic plaque formation group(plaque group,n=48).Serum ADAM10 levels were compared among three groups,and the risk factors of AS were analyzed by Logistic regression.According to the condition of blood vessels,the patients were subdivided into non-atherosclersis group(n=25)and atherosclersis group(n=62).The diagnostic value of serum ADAM10 level was analyzed using receiver operating characteristic(ROC)curve.Results Serum ADAM10 level increased gradually according to the degree of carotid atherosclerosisnon-atherosclerosis group(1676.12±736.42)pg/ml,IMT thickening group(1835.00±798.79)pg/ml and atherosclerotic plaque formation group(2016.77±787.63)pg/ml],but there were no significant differences in it among three groups(P>0.05).Logistic regression analysis showed that longer duration of diabetes,aging,higher systolic blood pressure and higher serum ADAM10 level were the risk factors for aggravation of AS in T2 DM patients.The area under ROC curve(AUC)of serum ADAM10 level in predicting T2 DM complicated with AS was 0.612(95%CI:0.480,0.743),the optimal cut-off value was 1426.50 pg/ml,and the sensitivity and the specificity were 0.82 and 0.44,respectively.Conclusion Longer duration of diabetes,aging,higher systolic blood pressure and higher serum ADAM10 level are the risk factors for the aggravation of carotid atherosclerosis in T2 DM patients.Elevated serum ADAM10 may have a warning effect on T2 DM complicated with cervical atherosclerosis.