血清NGAL及sdLDL-C水平对老年T2DM患者MACCE的预测价值

doi:10.3760/cma.j.cn441417-20240530-10010

摘要/Abstract

摘要：

目的　探讨小而密低密度脂蛋白胆固醇（sdLDL-C）及血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平对老年2型糖尿病（T2DM）患者主要不良心脑血管事件（MACCE）的预测价值。方法　选取天津医科大学总医院2020年6月至2023年1月收治的120例60岁以上T2DM患者进行病例对照研究，其中男65例，女55例，年龄（73.12±9.33）岁。根据出院随访12个月期间是否出现MACCE将其分为预后良好组和预后不良组。记录、比较两组基线资料、实验室检查指标。多因素logistic回归分析老年T2DM患者并发MACCE的危险因素。采用受试者操作特征曲线（ROC）分析血清NGAL及sdLDL-C水平对老年T2DM患者MACCE的预测价值。结果　预后不良组血清HbA1c、LDL-C、sdlDL-C、ApoA-I、ApoB及NGAL水平与预后良好组比较，差异均有统计学意义（均P<0.05）。多因素logistic回归分析显示，血清sdlDL-C（OR=2.880，95%CI 1.336～6.918）及NGAL（OR=2.052，95%CI 1.880～4.120）水平升高是老年T2DM患者发生MACCE的独立危险因素。ROC分析结果显示，血清NGAL及sdLDL-C对老年T2DM患者MACCE均具有较高预测价值［曲线下面积（AUC）=0.791、0.760］，其截断值分别为131.81 μg/L、32.38 mg/dl，二者标联合诊断价值更高（AUC=0.871）。结论　血清NGAL及sdLDL-C水平升高均为老年T2DM患者MACCE的危险因素，对MACCE的发生具有一定的预测价值。

关键词: 2型糖尿病, , , 中性粒细胞明胶酶相关脂质运载蛋白, , , 小而密低密度脂蛋白胆固醇, , , 主要不良心脑血管事件, , , 预测价值

Abstract:

Objective　To investigate the value of serum levels of neutrophil gelatinase-associated lipid carrier protein (NGAL) and small and dense low-density lipoprotein cholesterol (sdLDL-C) in the prediction of major unconscience cerebrovascular events (MACCE) in elderly patients with type 2 diabetes mellitus (T2DM). Methods　A total of 120 elderly patients with T2DM who were over 60 years old and treated in General Hospital of Tianjin Medical University from June 2020 to January 2023 were selected for the case-control study, including 65 males and 55 females who were (73.12±9.33) years old. They were divided into a good prognosis group and a poor prognosis group according to whether MACCE occurred during 12 months' follow-up after discharge. The baseline data and laboratory indicators in both groups were recorded and compared. The risk factors of MACCE in the patients were analyzed by the multivariate logistic regression. The value of the serum levels of NGAL and sdLDL-C in the prediction of MACCE in the patients was analyzed by the receiver operating characteristic curve (ROC). Results　There were statistical differences in the serum levels of HbA1c, LDL-C, sdlDL-C, ApoA-I, ApoB, and NGAL between the poor prognosis group and the good prognosis group (all P<0.05). The multivariate logistic regression analysis showed that elevated serum levels of sdlDL-C (OR=2.880, 95%CI 1.336-6.918) and NGAL (OR=2.052, 95%CI 1.880-4.120) were independent risk factors for MACCE in the patients. The ROC analysis results showed that serum NGAL and sdLDL-C had high predictive value for MACCE in the patients [areas under the curves (AUC)=0.791 and 0.760], and their cut-off values were 131.81 μg/L and 32.38 mg/dl, respectively. The combined diagnostic value was higher (AUC=0.871). Conclusion　Elevated serum levels of NGAL and sdLDL-C both are risk factors for MACCE in elderly patients with T2DM, and have certain predictive value for the occurrence of MACCE.

Key words: Type 2 diabetes mellitus, , Neutrophil gelatinase-related lipid carrier protein, , Small and dense low-density lipoprotein cholesterol, , Major unconscionable cerebrovascular events, , Predictive value

张红艳刘铭刘丽丽锁冬梅. 血清NGAL及sdLDL-C水平对老年T2DM患者MACCE的预测价值 [J]. 国际医药卫生导报, 2025, 31(10): 1632-1636.

Zhang Hongyan, Liu Ming, Liu Lili, Suo Dongmei.

Value of serum levels of NGAL and sdLDL-C in prediction of major cardiovascular and cerebrovascular adverse events in elderly patients with type 2 diabetes mellitus [J]. International Medicine and Health Guidance News, 2025, 31(10): 1632-1636.

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