天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2014年
5期
458-461
,共4页
糖尿病, 1型%糖尿病, 2型%ROC曲线%成人隐匿性自身免疫性糖尿病%C1酯酶抑制物
糖尿病, 1型%糖尿病, 2型%ROC麯線%成人隱匿性自身免疫性糖尿病%C1酯酶抑製物
당뇨병, 1형%당뇨병, 2형%ROC곡선%성인은닉성자신면역성당뇨병%C1지매억제물
diabetes mellitus,type 1%diabetes mellitus,type 2%ROC curve%latent autoimmune diabetes in adults%plasma protease C1 inhibitor
目的：检测成人隐匿性自身免疫性糖尿病（LADA）患者早期血浆中C1酯酶抑制物（SERPING1）的水平，探讨其临床意义。方法检测LADA组患者SERPING1水平，并与1型糖尿病（T1DM）组、2型糖尿病（T2DM）组和正常对照组进行比较。对SERPING1与年龄、病程、糖化血红蛋白（HbA1c）、空腹血糖（FPG）、餐后2 h血糖（2 hPG）、空腹C肽（FCP）、餐后2 hC肽（2hCP）进行相关性分析和多元逐步回归分析。采用受试者工作特征曲线（ROC曲线）分析SERPING1早期预测LADA的效果。结果 LADA组血浆SERPING1水平(325.00±72.70)明显高于T2DM组(296.45±71.20)和正常对照组(292.04±58.46)，差异有统计学意义；SERPING1与FCP呈负相关(rs=-0.680)，与HbA1c、FPG、2 hPG呈正相关（rs分别为0.550、0.547、0.476，P＜0.05），与年龄、病程、2 hCP等其他指标无明显相关性。FCP可进入回归方程（P＜0.05），是血浆SERPING1的主要影响因素。ROC曲线下面积（AUC）为0.613（P＜0.05），95%CI为0.514~0.712。SERPING1早期预测LADA的最佳临界值为289.71 mg/L，灵敏度69%，特异度48%。结论 SERPING1结合其他指标可能成为早期预测LADA的有效指标，帮助临床早期鉴别LADA与T2DM。
目的：檢測成人隱匿性自身免疫性糖尿病（LADA）患者早期血漿中C1酯酶抑製物（SERPING1）的水平，探討其臨床意義。方法檢測LADA組患者SERPING1水平，併與1型糖尿病（T1DM）組、2型糖尿病（T2DM）組和正常對照組進行比較。對SERPING1與年齡、病程、糖化血紅蛋白（HbA1c）、空腹血糖（FPG）、餐後2 h血糖（2 hPG）、空腹C肽（FCP）、餐後2 hC肽（2hCP）進行相關性分析和多元逐步迴歸分析。採用受試者工作特徵麯線（ROC麯線）分析SERPING1早期預測LADA的效果。結果 LADA組血漿SERPING1水平(325.00±72.70)明顯高于T2DM組(296.45±71.20)和正常對照組(292.04±58.46)，差異有統計學意義；SERPING1與FCP呈負相關(rs=-0.680)，與HbA1c、FPG、2 hPG呈正相關（rs分彆為0.550、0.547、0.476，P＜0.05），與年齡、病程、2 hCP等其他指標無明顯相關性。FCP可進入迴歸方程（P＜0.05），是血漿SERPING1的主要影響因素。ROC麯線下麵積（AUC）為0.613（P＜0.05），95%CI為0.514~0.712。SERPING1早期預測LADA的最佳臨界值為289.71 mg/L，靈敏度69%，特異度48%。結論 SERPING1結閤其他指標可能成為早期預測LADA的有效指標，幫助臨床早期鑒彆LADA與T2DM。
목적：검측성인은닉성자신면역성당뇨병（LADA）환자조기혈장중C1지매억제물（SERPING1）적수평，탐토기림상의의。방법검측LADA조환자SERPING1수평，병여1형당뇨병（T1DM）조、2형당뇨병（T2DM）조화정상대조조진행비교。대SERPING1여년령、병정、당화혈홍단백（HbA1c）、공복혈당（FPG）、찬후2 h혈당（2 hPG）、공복C태（FCP）、찬후2 hC태（2hCP）진행상관성분석화다원축보회귀분석。채용수시자공작특정곡선（ROC곡선）분석SERPING1조기예측LADA적효과。결과 LADA조혈장SERPING1수평(325.00±72.70)명현고우T2DM조(296.45±71.20)화정상대조조(292.04±58.46)，차이유통계학의의；SERPING1여FCP정부상관(rs=-0.680)，여HbA1c、FPG、2 hPG정정상관（rs분별위0.550、0.547、0.476，P＜0.05），여년령、병정、2 hCP등기타지표무명현상관성。FCP가진입회귀방정（P＜0.05），시혈장SERPING1적주요영향인소。ROC곡선하면적（AUC）위0.613（P＜0.05），95%CI위0.514~0.712。SERPING1조기예측LADA적최가림계치위289.71 mg/L，령민도69%，특이도48%。결론 SERPING1결합기타지표가능성위조기예측LADA적유효지표，방조림상조기감별LADA여T2DM。
Objective To examine plasma levels of protease C1 inhibitor (SERPING1) in adult patients with latent autoimmune diabetes (LADA), and their clinical significance thereof. Methods The levels of SERPING1 were detected and compared between LADA, type 1 diabetes (T1DM), type 2 diabetes (T2DM) and healthy control groups. The correlation between plasma levels of SERPING1 and other clinical indicators such as age, disease course, glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), 2 h postprandial plasma glucose (2 hPG), fasting c-peptide (FCP) and 2 h postprandi-al C peptide (2 hCP) was analyzed. Multi-factor regression analysis and receiver operating characteristic (ROC) were used to evaluate the predictive effect of SERPING1 in LADA at the early stage. Results The level of SERPING1 was significantly higher in LADA group than that of T2DM group and control group (P < 0.05). There was a negative correlation between SERPING1 and FCP, and a positive correlation between SERPING1 and HbA1c, FPG and 2 hPG (P<0.05). There were no significant correlation between SERPING1 and age, disease course and 2 hCP. FCP was analyzed by regression equation (P<0.05), and which was the main influence factor of the plasma level of SERPING1. The area under the ROC curve (AUC) of SERPING1 was 0.613 (P<0.05), 95%CI 0.514-0.712. The optimal cut-point of SERPING1 for early prediction of LADA was 289.71 mg/L, and the sensitivity and specificity were 69%and 48%respectively. Conclusion SERPING1 combined with other indicators will be useful for identifying LADA from T2DM at the early stage.
