血清 Metrnl、RANTES 水平与 2 型糖尿病患者 并发冠心病的关系.

Objective To investigate the relationships between the levels of serum meteorin-like glial cell differentiation regulator (Metrnl), regulated upon activation, normal T-cell expressed and secreted (RANTES) and type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD) . Methods A total of 240 patients with T2DM who had coronary angiography (T2DM group) were selected and divided into the CHD group of 129 cases and non-CHD group of 111 cases according to the coronary angiography results, and another 64 healthy volunteers with physical examination were selected during the same period (control group) . The clinical data of T2DM patients were collected and serum Metrnl and RANTES levels were measured by enzyme-linked immunosorbent assay. Spearman's correlation coefficient was used to analyze the correlations between serum Metrnl and RANTES levels and Gensini score in T2DM patients, and multifactor Logistic regression was used to analyze the factors influencing T2DM complicated with CHD, and receiver operating characteristic (ROC) curves were used to analyze the predictive value of serum Metrnl and RANTES levels on T2DM complicated with CHD. Results Compared with the control group, serum Metrnl levels decreased and RANTES levels increased in the T2DM group (both P<0. 05). Serum Metrnl levels were lower and RANTES levels were higher in the CHD group than in the non-CHD group (both P<0. 05). Spearman's correlation analysis showed a negative correlation between Gensini score and serum Metrnl level and a positive correlation with RANTES level in T2DM patients (rs = -0.657, 0.683, both P<0.05) . Multi-factor Logistic regression analysis showed that increased body mass index (OR=1.145, 95% CI：1.008 to 1.300), prolonged duration of T2DM (OR=1. 120, 95% CI: 1.038 to 1. 208), elevated LDL cholesterol (OR = 1.959, 95% CI：1.009 to 3.805), elevated glycated hemoglobin A1c (OR = 1.361, 95% CI：1. 079 to 1. 718), and elevated RANTES (OR=1.329, 95% CI：1.057 to 1.671) were independent risk factors for T2DM complicated with CHD; and elevated Metrnl (OR = 0.893, 95% CI：0.867 to 0.919) was an independent protective factor (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum Metrnl and RANTES levels alone and in combination in predicting T2DM complicated with CHD were 0.774, 0.760, and 0.855, respectively, and the AUC of the combination of the two was greater than that of either index alone (all P<0.05). Conclusion The serum Metrnl and RANTES levels are closely related to the degree of coronary artery disease in T2DM patients, and are independent influencing factors for T2DM combined with CHD, which can be used as the predictors of T2DM patients with CHD. [ABSTRACT FROM AUTHOR]