胎球蛋白A-脂聯(lián)素比值在2型糖尿病合并頸動(dòng)脈粥樣硬化中的相關(guān)性研究

胎球蛋白A-脂聯(lián)素比值在2型糖尿病合并頸動(dòng)脈粥樣硬化中的相關(guān)性研究摘要：

目的：探討胎球蛋白A（fetuin-A）/脂聯(lián)素（adiponectin）比值在2型糖尿病（T2DM）合并頸動(dòng)脈粥樣硬化（CAS）中的相關(guān)性，以提高T2DM合并CAS的早期診斷和治療水平。

方法：選取195例T2DM患者，其中105例合并CAS，另外90例為非CAS對(duì)照組。采用ELISA法測(cè)定fetuin-A和adiponectin水平，計(jì)算其比值。通過分析各項(xiàng)指標(biāo)與CAS的相關(guān)性，得出fetuin-A/adiponectin比值在T2DM合并CAS中的作用。

結(jié)果：合并CAS組與非CAS組的fetuin-A水平差異顯著（P＜0.01），而adiponectin水平差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。合并CAS組fetuin-A/adiponectin比值高于非CAS組（P＜0.01）。常規(guī)臨床指標(biāo)中，收縮壓、低密度脂蛋白膽固醇、甘油三酯、空腹血糖、糖化血紅蛋白等在T2DM合并CAS中均有明顯差異（P＜0.05），其中糖化血紅蛋白與fetuin-A/adiponectin比值相關(guān)性最強(qiáng)。

結(jié)論：fetuin-A和adiponectin均與T2DM合并CAS有關(guān)，但fetuin-A/adiponectin比值更能反映CAS的危險(xiǎn)性。fetuin-A/adiponectin比值在T2DM合并CAS的早期診斷、疾病評(píng)價(jià)和治療方案制定方面具有一定價(jià)值。

關(guān)鍵詞：胎球蛋白A/脂聯(lián)素比值；2型糖尿??；頸動(dòng)脈粥樣硬化；ELISA

Abstract:

Objective:Toinvestigatethecorrelationbetweenfetuin-A/adiponectinratioandcervicalatherosclerosis(CAS)intype2diabetesmellitus(T2DM)patients,inordertoimprovetheearlydiagnosisandtreatmentofT2DMwithCAS.

Methods:195T2DMpatientswereselected,including105withCASand90without.ELISAwasusedtodetectthelevelsoffetuin-Aandadiponectin,andtheirratiowascalculated.ThecorrelationbetweenvariousindicatorsandCASwasanalyzed,andtheroleoffetuin-A/adiponectinratioinT2DMwithCASwasderived.

Results:Therewassignificantdifferenceinfetuin-AlevelsbetweentheCASandnon-CASgroups(P＜0.01),whiletherewasnosignificantdifferenceinadiponectinlevels(P>0.05).Thefetuin-A/adiponectinratiointheCASgroupwashigherthanthatinthenon-CASgroup(P＜0.01).Amongtheroutineclinicalindicators,systolicbloodpressure,low-densitylipoproteincholesterol,triglyceride,fastingbloodglucose,andglycatedhemoglobinweresignificantlydifferentbetweenT2DMwithCASandwithout(P＜0.05),withglycatedhemoglobinshowingthestrongestcorrelationwithfetuin-A/adiponectinratio.

Conclusion:Fetuin-AandadiponectinwereassociatedwithT2DMwithCAS,butfetuin-A/adiponectinratiocouldbetterreflecttheriskofCAS.Fetuin-A/adiponectinratiohascertainvalueinearlydiagnosis,diseaseevaluationandtreatmentplanofT2DMwithCAS.

Keywords:Fetuin-A/adiponectinratio;Type2diabetesmellitus;Cervicalatherosclerosis;ELISInrecentyears,theincidenceofT2DMhasbeenincreasinggloballywiththeassociatedrisksofcardiovasculardisease.CASisoneofthecommoncomplicationsofT2DM,whichaffectsthequalityoflifeandincreasesthemorbidityandmortalityrates.Thus,earlydiagnosisandeffectiveinterventionsareessentialtoreducetheriskofCASinT2DMpatients.

Fetuin-AandadiponectinaretwobiomarkersthathavebeenreportedtohaveacloseassociationwithT2DManditscomplications,includingCAS.Thisstudyhasdemonstratedthatbothfetuin-AandadiponectinweresignificantlydifferentinT2DMpatientswithandwithoutCAS.Furthermore,thefetuin-A/adiponectinratioshowedabettercorrelationwithCASthantheindividualbiomarkers.

Thefindingsofthisstudysuggestthatthefetuin-A/adiponectinratiomaybeapotentialpredictorofCASinT2DMpatients.Itcouldserveasanon-invasiveandcost-effectivebiomarkerforearlydiagnosisandriskassessmentofCASinT2DMpatients.CliniciansandresearcherscouldusethisratioasatooltodevelopeffectivetreatmentplanstopreventorreducetheincidenceofCASinT2DMpatients.

Inconclusion,thepresentstudyprovidesnewinsightsintotheroleoffetuin-AandadiponectininT2DMpatientswithCAS.Thefindingssuggestthatthefetuin-A/adiponectinratiocouldserveasausefulbiomarkerfortheearlydiagnosisandriskassessmentofCASinT2DMpatients.FurtherstudiesarerequiredtovalidatethisbiomarkeranddevelopeffectiveinterventionstopreventortreatCASinT2DMpatientsInadditiontoaddressingtheroleoffetuin-AandadiponectinaspotentialbiomarkersforCASinT2DMpatients,itisimportanttoconsiderotherfactorsthatmaycontributetothedevelopmentandprogressionofCASinthispopulation.Onesuchfactorisglycemiccontrol.Poorglycemiccontrolhasbeenshowntobeasignificantriskfactorforthedevelopmentofcardiovasculardisease,includingCAS(Kanneletal.,1974).Therefore,treatmentplansforT2DMpatientsshouldprioritizetheachievementandmaintenanceofoptimalglycemiccontrol.

Lifestylemodifications,suchasahealthydietandregularexercise,havealsobeenshowntobeeffectiveinpreventingandreducingtheincidenceofcardiovasculardiseaseinT2DMpatients(AmericanDiabetesAssociation,2019).Specifically,adietthatislowinsaturatedandtransfatsandhighinfruits,vegetables,wholegrains,andleanproteinscanimprovecardiovascularhealthandreducetheriskofCAS.Similarly,regularphysicalactivitycanimprovebloodglucosecontrol,lipidlevels,andoverallcardiovascularhealth,therebyreducingtheriskofCAS.

Finally,pharmacologicalinterventionsmaybenecessarytopreventortreatCASinT2DMpatients.Medicationsthattargetcardiovascularriskfactors,suchashypertensionanddyslipidemia,canbeeffectiveinreducingtheincidenceandseverityofCASinthispopulation(AmericanDiabetesAssociation,2019).Additionally,medicationsthattargetinflammation,suchasstatinsandanti-inflammatoryagents,mayalsobeeffectiveinpreventingortreatingCASinT2DMpatients.

Inconclusion,thedevelopmentandprogressionofCASinT2DMpatientsisacomplexprocessthatisinfluencedbymultiplefactors,includingglycemiccontrol,lifestylefactors,andpharmacologicalinterventions.FurtherresearchisneededtobetterunderstandthepathophysiologyofCASinT2DMpatientsandtodevelopeffectivestrategiesforpreventingandtreatingthiscondition.Byaddressingtheroleofbiomarkerssuchasfetuin-Aandadiponectin,optimizingglycemiccontrol,promotinghealthylifestylehabits,andutilizingpharmacologicalinterventionswhennecessary,itmaybepossibletoreducetheincidenceandseverityofCASinthisvulnerablepopulationInadditiontotheapproachesmentionedabove,thereareotherpotentialinterventionsthatmayhelppreventortreatCASinT2DMpatients.Onesuchstrategyistheuseofstatins,whichareaclassofdrugsthatcanlowercholesterollevelsandarecommonlyprescribedtopatientswithcardiovasculardisease.Severalstudieshaveshownthatstatinscanalsoimproveendothelialfunctionandreducearterialstiffness,bothofwhichcouldhelppreventthedevelopmentorprogressionofCAS(Siasosetal.,2013).However,notallstudieshaveshownabenefitofstatintherapyinpreventingortreatingCAS,andmoreresearchisneededtodeterminetheoptimaluseofthesedrugsinT2DMpatients.

Anotherpotentialinterventionistheuseofantihypertensivemedications,whichcanlowerbloodpressureandimprovearterialfunction.SeveralstudieshavedemonstratedthatantihypertensivetherapycanreducearterialstiffnessinT2DMpatients(Cicconeetal.,2012),andsomestudieshavealsoshownthatspecificclassesofantihypertensivemedications,suchascalciumchannelblockersorACEinhibitors,maybeparticularlyeffectiveinimprovingarterialstiffness(Lukichetal.,2011).However,again,moreresearchisneededtodeterminetheoptimaluseofthesedrugsinT2DMpatientswithCAS.

Finally,exercisemayalsobeanimportantinterventionforpreventingandtreatingCASinT2DMpatients.Exercisecanimproveendothelialfunction,reducearterialstiffness,andimproveglycemiccontrol,allofwhichcouldpotentiallyhaveapositiveimpactonCAS.SeveralstudieshavedemonstratedthatregularexercisecanimprovearterialstiffnessinT2DMpatients(Leeetal.,2012),andtheAmericanDiabetesAssociationrecommendsatleast150minutesofmoderate-intensityexerciseperweekforindividualswithdiabetes(AmericanDiabetesAssociation,2021).However,itisimportanttonotethatexercisemayneedtobecarefullytailoredtothespecificneedsandlimitationsofindividualpatients,particularlythosewithothercomorbiditiesormobilityissues.

Insummary,CASisacommoncomplicationofT2DMthatisassociatedwithincreasedcardiovascularriskandpooroutcomes.ThereisstillmuchthatisnotfullyunderstoodaboutthepathophysiologyofCAS,andmoreresearchisneededtodevelopeffectivepreventionandtreatmentstrategies.However,currentevidencesuggeststhatoptimizingglycemiccontrol,promotinghealthylifestylehabits,usingpharmacolo