尿N-乙酰-β-D-氨基葡萄糖苷酶在2型糖尿病亚临床动脉粥样硬化中的变化及预测价值

目的探讨尿N-乙酰-β-D-氨基葡萄糖苷酶(UNAG)在T2DM亚临床动脉粥样硬化(SAS)患者中的变化及预测价值。方法选取2018年3月至2019年2月于玉林市第一人民医院内分泌科就诊的T2DM患者259例,根据颈动脉超声检测结果分为SAS组149例和单纯T2DM组(T2DM)110例。收集临床资料并检测生化指标、UNAG及UACR。结果SAS组UNAG、UACR高于T2DM组20.00(15.50,28.00)vs 7.50(5.00,12.05)U/L;7.81(4.39,14.46)vs 4.72(2.79,8.81)mg/g,P<0.05]。Spearman相关性分析显示,UANG与TC、LDL-C、FPG、2 h PG、HbA1c、UACR呈正相关(r=0.123、0.166、0.208、0.155、0.206、0.243,P<0.05);UACR与年龄、BMI、WC、SBP、DBP、UNAG呈正相关(r=0.186、0.153、0.184、0.207、0.151、0.288,P<0.05)。多因素Logistic回归分析显示,年龄、吸烟史、UNAG、UACR是SAS的影响因素。UNAG、UACR受试者工作特征曲线下面积为0.902、0.685,约登指数为0.691、0.314,敏感度为84.6%、70.5%,特异度为84.5%、60.9%。结论UNAG可能与T2DM患者SAS发生发展相关。UNAG预测T2DM合并SAS的切点为13.75 U/L。UNAG不受BP影响,相比UACR能更好地预测T2DM患者SAS。

The changes and predictive value of urinary N-acetyl-beta-D-glucosaminidase in type 2 diabetes mellitus with subclinica atherosclerosis

Objectives To investigate the changes and predictive value of Urinary N-acetyl-glucosaminidase(UNAG)in type 2 diabetes mellitus(T2DM)with subclinical atherosclerosis.Methods A total of 259 patients with T2DM were selected.According to the results of carotid artery ultrasound,the patients were divided into subclinical atherosclerosis group(SAS,n=149)and non-subclinical atherosclerosis group(Non-SAS,n=110).Clinical data were collected and biochemical indicators,UNAG and urinary albumin/creatinine ratio(UACR)were detected.Results The levels of UNAG and UACR in SAS group were significantly higher than those in T2DM group20.00(15.50,28.00)vs 7.5(5.00,12.05)U/L;7.81(4.39,14.46)vs 4.72(2.79,8.81)mg/g,P<0.05].Correlation analysis showed that UANG was positively correlated with TC,LDL-C,FPG,2 h PG,HbA1c and UACR in T2DM patients(r=0.123,0.166,0.208,0.155,0.206,0.243,P<0.05).UACR was positively correlated with age,BMI,WC,SBP,DBP and UNAG in T2DM patients(r=0.186,0.153,0.184,0.207,0.151,0.288,P<0.05).Multivariate logistic regression analysis showed that age,smoking,UNAG and UACR were correlated with SAS in T2DM.The ROC area under curve of UACR and UNAG was 0.902 and 0.685,and the Youden index was 0.691 and 0.314 respectively.The corresponding sensitivity was 84.6%and 70.5%,the specificity was 84.5%and 60.9%respectively.Conclusion UNAG may be associated with the development of SAS in patients with T2DM.The cut point of UNAG for predicting SAS was 13.75 U/L.UNAG was not affected by blood pressure,so it can better predict SAS than UACR in patients with T2DM.