血清YKL-40水平与糖尿病足病的相关性探讨
发布时间：2018-11-01 16:54
【摘要】：目的几丁质酶3样蛋白1(YKL-40)是近些年来新发现的一种炎症因子,参与了炎症、血管病变和动脉粥样硬化的发生、发展过程。本试验的目的在于探讨血清YKL-40水平与糖尿病足病的相关性。方法按照1999年WHO糖尿病诊断标准,选取2015年3月至2016年10月在华北理工大学附属开滦总医院内分泌科住院的糖尿病患者121例,按是否患有糖尿病足病将所有受试对象分为糖尿病足病组(DF组,69例)和2型糖尿病组(DM组,52例)。按足部是否存在缺血分为2个亚组:缺血组36例和非缺血组33例。记录所有受试对象的一般临床资料及DF组患者的Wagner分级情况,采用酶联免疫吸附双抗体夹心法测定所有受试对象的血清YKL-40水平,并测定生化指标、超敏C反应蛋白(hs-CRP)以及糖化血红蛋白(Hb A1c)水平。对血清YKL-40水平在各组间的差异及其与糖尿病足病之间的关系进行分析。结果1 DF组和DM组的比较:与DM组相比,DF组的病程、空腹血糖(FPG)、hs-CRP及血清YKL-40水平均明显升高(均P0.05),差异有统计学意义;DF组的血红蛋白(Hb)和总胆红素均明显降低(均P0.05),差异具有统计学意义。血清YKL-40浓度在110.16ng/ml以上的糖尿病患者发生DF的相对危险度(OR值)为13.537,说明DM患者血清YKL-40浓度在110.16ng/ml以上时,患DF的风险是YKL-40在110.16ng/ml以下的13.537倍。进一步以糖尿病是否合并DF为因变量,将DF组和DM组之间具有显著性差异的指标作为协变量引入多因素Logistic回归模型中进行分析。结果显示,YKL-40是DF的危险因素。2缺血组和非缺血组的比较:与非缺血组相比,缺血组的病程、FPG、hs-CRP及血清YKL-40水平均明显升高(均P0.05),差异具有统计学意义;缺血组的Hb、总胆红素及HDL均明显降低(均P0.05),差异具有统计学意义;血清YKL-40浓度在123.90ng/ml以上的DF患者发生缺血性糖尿病足病的相对危险度(OR值)为3.538,说明DF患者血清YKL-40浓度在123.90ng/ml以上时,患缺血性糖尿病足病的风险是YKL-40在123.90ng/ml以下的3.538倍。进一步以DF是否合并缺血为因变量,以缺血组和非缺血组两组间具有显著差异的指标为协变量引入多因素Logistic回归模型进行分析,结果显示,YKL-40为缺血性糖尿病足病的危险因素。结论1血清YKL-40水平与糖尿病足病呈正相关,参与了糖尿病足病的发生和发展过程。2血清YKL-40水平与糖尿病足病足部缺血程度呈正相关。
[Abstract]:Objective chitinase 3 like protein 1 (YKL-40) is a newly discovered inflammatory factor in recent years, which is involved in the occurrence and development of inflammation, vascular disease and atherosclerosis. The aim of this study was to investigate the correlation between serum YKL-40 level and diabetic foot disease. Methods according to the diagnosis criteria of WHO diabetes in 1999, 121 diabetic patients were selected from March 2015 to October 2016 in the Department of Endocrinology, Kailuan General Hospital affiliated to North China University of Technology. All subjects were divided into diabetic foot disease group (DF group, 69 cases) and type 2 diabetes mellitus group (DM group, 52 cases). According to whether there was ischemia in the foot, there were two subgroups: 36 cases in ischemic group and 33 cases in non-ischemic group. The general clinical data of all subjects and the Wagner grading of patients in DF group were recorded. The serum YKL-40 levels and biochemical indexes were measured by enzyme-linked immunosorbent assay (Elisa). The levels of high sensitive C reactive protein (hs-CRP) and glycosylated hemoglobin (Hb A 1c). The relationship between serum YKL-40 level and diabetic foot disease was analyzed. Results 1 comparison between DF group and DM group: compared with DM group, the course of disease, fasting blood glucose (FPG), hs-CRP and serum YKL-40 level in DF group were significantly higher than those in DM group (P0.05). Hemoglobin (Hb) and total bilirubin were significantly decreased in DF group (P0.05). The relative risk (OR value) of DF in diabetic patients whose serum YKL-40 concentration was above 110.16ng/ml was 13.537, which indicated that the serum YKL-40 level of DM patients was above 110.16ng/ml. The risk of DF is 13.537 times higher than that of YKL-40 below 110.16ng/ml. Furthermore, whether diabetes mellitus complicates DF as dependent variable, the significant difference between DF group and DM group was introduced into multivariate Logistic regression model as a covariable. The results showed that YKL-40 was a risk factor for DF. 2 comparison between ischemic group and non-ischemic group: compared with non-ischemic group, the course of disease, FPG,hs-CRP and serum YKL-40 levels in ischemic group were significantly higher than those in non-ischemic group (P0.05). The difference is statistically significant. The total bilirubin and HDL in ischemic group were significantly decreased (P0.05), the difference was statistically significant. The relative risk (OR) of ischemic diabetic foot disease (OR) was 3.538 in patients with DF whose serum YKL-40 concentration was above 123.90ng/ml, indicating that the serum YKL-40 level in DF patients was above 123.90ng/ml. The risk of ischemic diabetic foot disease is 3.538 times higher than that of YKL-40 below 123.90ng/ml. Furthermore, the multivariate Logistic regression model was introduced to analyze whether DF was associated with ischemia or not, and the significant differences between ischemic group and non-ischemic group were used as covariates, and the results showed that there were significant differences between ischemic group and non-ischemic group. YKL-40 was a risk factor for ischemic diabetic foot disease. Conclusion (1) the level of serum YKL-40 is positively correlated with diabetic foot disease, which is involved in the occurrence and development of diabetic foot disease, and the level of serum YKL-40 is positively correlated with the degree of diabetic foot ischemia.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2
本文编号：2304520
[Abstract]:Objective chitinase 3 like protein 1 (YKL-40) is a newly discovered inflammatory factor in recent years, which is involved in the occurrence and development of inflammation, vascular disease and atherosclerosis. The aim of this study was to investigate the correlation between serum YKL-40 level and diabetic foot disease. Methods according to the diagnosis criteria of WHO diabetes in 1999, 121 diabetic patients were selected from March 2015 to October 2016 in the Department of Endocrinology, Kailuan General Hospital affiliated to North China University of Technology. All subjects were divided into diabetic foot disease group (DF group, 69 cases) and type 2 diabetes mellitus group (DM group, 52 cases). According to whether there was ischemia in the foot, there were two subgroups: 36 cases in ischemic group and 33 cases in non-ischemic group. The general clinical data of all subjects and the Wagner grading of patients in DF group were recorded. The serum YKL-40 levels and biochemical indexes were measured by enzyme-linked immunosorbent assay (Elisa). The levels of high sensitive C reactive protein (hs-CRP) and glycosylated hemoglobin (Hb A 1c). The relationship between serum YKL-40 level and diabetic foot disease was analyzed. Results 1 comparison between DF group and DM group: compared with DM group, the course of disease, fasting blood glucose (FPG), hs-CRP and serum YKL-40 level in DF group were significantly higher than those in DM group (P0.05). Hemoglobin (Hb) and total bilirubin were significantly decreased in DF group (P0.05). The relative risk (OR value) of DF in diabetic patients whose serum YKL-40 concentration was above 110.16ng/ml was 13.537, which indicated that the serum YKL-40 level of DM patients was above 110.16ng/ml. The risk of DF is 13.537 times higher than that of YKL-40 below 110.16ng/ml. Furthermore, whether diabetes mellitus complicates DF as dependent variable, the significant difference between DF group and DM group was introduced into multivariate Logistic regression model as a covariable. The results showed that YKL-40 was a risk factor for DF. 2 comparison between ischemic group and non-ischemic group: compared with non-ischemic group, the course of disease, FPG,hs-CRP and serum YKL-40 levels in ischemic group were significantly higher than those in non-ischemic group (P0.05). The difference is statistically significant. The total bilirubin and HDL in ischemic group were significantly decreased (P0.05), the difference was statistically significant. The relative risk (OR) of ischemic diabetic foot disease (OR) was 3.538 in patients with DF whose serum YKL-40 concentration was above 123.90ng/ml, indicating that the serum YKL-40 level in DF patients was above 123.90ng/ml. The risk of ischemic diabetic foot disease is 3.538 times higher than that of YKL-40 below 123.90ng/ml. Furthermore, the multivariate Logistic regression model was introduced to analyze whether DF was associated with ischemia or not, and the significant differences between ischemic group and non-ischemic group were used as covariates, and the results showed that there were significant differences between ischemic group and non-ischemic group. YKL-40 was a risk factor for ischemic diabetic foot disease. Conclusion (1) the level of serum YKL-40 is positively correlated with diabetic foot disease, which is involved in the occurrence and development of diabetic foot disease, and the level of serum YKL-40 is positively correlated with the degree of diabetic foot ischemia.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2
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