文章摘要
孙雅军,姬媛,袁举.血浆氧化低密度脂蛋白、谷胱甘肽过氧化物酶表达与儿童 Ⅰ型糖尿病及胰岛素抵抗的相关性研究[J].安徽医药,2022,26(1):45-48.
血浆氧化低密度脂蛋白、谷胱甘肽过氧化物酶表达与儿童 Ⅰ型糖尿病及胰岛素抵抗的相关性研究
Relationship between the expressions of plasma ox-LDL, GSH-Px and type Ⅰ diabetes mellitus, insulin resistance in children
  
DOI:10.3969/j.issn.1009-6469.2022.01.010
中文关键词: 糖尿病, 1型  胰岛素抗药性  氧化低密度脂蛋白  谷胱甘肽过氧化物酶  儿童
英文关键词: Diabetes mellitus, type 1  Insulin resistance  Oxidized low-density lipoprotein  Glutathione peroxidase  Child
基金项目:2018年河南省科技攻关项目( 182102310176)
作者单位E-mail
孙雅军 开封市儿童医院内分泌遗传代谢科河南开封 475000  
姬媛 开封市儿童医院内分泌遗传代谢科河南开封 475000 jiyuan6701@126.com 
袁举 河南省人民医院内分泌科河南郑州 454002  
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中文摘要:
      目的探讨血浆氧化低密度脂蛋白(ox-LDL)、谷胱甘肽过氧化物酶( GSH-PX)表达与儿童 I型糖尿病(T1DM)及胰岛素抵抗(IR)的相关性。方法选取 2017年 1月至 2019年 10月开封市儿童医院收治的 113例 T1DM病儿为观察组,另外选取同期健康体检儿童作为对照组。测定两组三酰甘油( TG)、总胆固醇( TC)、低密度脂蛋白胆固醇( LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖( FPG)、糖化血红蛋白( HbA1c)水平,采用稳态评估模型评估胰岛素抵抗指数( HOMA-IR)采用酶联免疫吸附法( ELISA)检测血浆 ox-LDL、GSH-PX表达水平,并进行组间比较;采用 Spearman分析观察组血浆 ox-LDL、G,SH-PX表达水平与 FPG、HbA1c、HOMA-IR相关性;绘制受试者工作特征( ROC)曲线评估血浆 ox-LDL、GSH-PX对儿童 T1DM的诊断价值;采用 logistic回归模型分析影响儿童发生 T1DM的因素。结果对照组与观察组性别、年龄、体质量指数( BMI)、 TC相比,均差异无统计学意义( P>0.05);与对照组相比,观察组 TG[( 1.35±0.24)mmol/L比( 0.81±0.21)mmol/L]、 LDL-C[( 2.97±0.58)mmol/L比(2.23±0.43)mmol/L]、 FPG[( 7.85±1.91)mmol/L比( 5.06±1.28)mmol/L]、 HbA1c[( 8.72±2.03)%比( 5.13±1.12)%]、 HOMA-IR[( 2.67±0.52)比( 1.51±0.33)]及血浆 ox-LDL表达[( 763.87±152.31)μg/L比( 584.82±109.64)μg/L]水平均较高( P<0.05),HDL-C[( 1.29±0.31)mmol/L比( 1.77±0.35)mmol/L]、 GSH-PX表达[( 105.61±15.27)μmol/L比( 132.03±25.36)μmol/L]水平较低( P< 0.05); Spearman结果显示,观察组血浆 ox-LDL与 FPG、HbA1c、HOMA-IR均呈正相关( P<0.05)GSH-PX与 FPG、HbA1c、HOMA-IR均呈负相关( P<0.05);血浆 ox-LDL、GSH-PX单独及两者联合诊断儿童 T1DM的曲线下积( AUC)分别为 0.832、0.816、面,0.887,ox-LDL单独诊断的截断值为 679.64 μg/L,敏感度、特异度分别为 71.70%、82.90%,GSH-PX单独诊断的截断值为 122.70 μmol/L,敏感度、特异度分别为 88.50%、69.50%,两者联合诊断的敏感度为 80.50%,特异度为 86.70%,较单独诊断特异度有所提高;多因素 logistic回归分析结果表明, TG、LDL-C、ox-LDL是儿童发生 T1DM的独立危险因素( P<0.05),HDL-C、GSH-PX是儿童发生 T1DM的独立保护因素( P<0.05)。结论 T1DM病儿血浆 ox-LDL为高表达, GSH-PX为低表达,与 T1DM的发生、发展密切相关,有一定诊断价值,可能为 T1DM的早期诊断及病情评估提供临床参考依据。
英文摘要:
      Objective To investigate the relationship between the expressions of oxidized low density lipoprotein (ox-LDL) and glu-tathione peroxidase (GSH-Px) in children with type I diabetes mellitus (T1DM) and insulin resistance (IR).Methods A total of 113 cases of T1DM in Kaifeng Children's Hospital from January 2017 to October 2019 were selected as the observation group, and thehealthy children in the same period were selected as the control group. The levels of triglyceride (TG), total cholesterol (TC), low densi-ty lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FPG), glycosylated hemoglobin(HbA1c) were measured, homeostasis assessment model was used to evaluate insulin resistance index (HOMA-IR), the expression lev-els of ox-LDL and GSH-Px in plasma were detected by enzyme-linked immunosorbent assay (ELISA), and comparisons were made be-tween groups; Spearman was used to analyze the correlation between the expression levels of ox-LDL, GSH-Px and FPG, HbA1c, HOMA-IR in the observation group; receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of plasma ox-LDL and GSH-Px in children with T1DM; and Logistic regression model was used to analyze the influencing factors of T1DM in chil-dren.Results There was no significant difference in gender, age, body mass index (BMI) and TC between the control group and the ob-servation group (P>0.05); the expression levels of TG [(1.35±0.24) vs. (0.81±0.21)] mmol/L, LDL-C [(2.97±0.58) vs. (2.23±0.43)] mmol/ L, FPG [(7.85±1.91) vs. (5.06±1.28)] mmol/L, HbA1c [(8.72±2.03) vs. (5.13±1.12)]%, HOMA-IR [(2.67±0.52) vs. (1.51±0.33)] and plas-ma ox-LDL [(763.87±152.31) vs. (584.82±109.64)] μg/L in the observation group were higher than those in the control group (P<0.05), while the expression levels of HDL-C [(1.29±0.31) vs. (1.77±0.35)] mmol/L and GSH-Px [(105.61±15.27) vs. (132.03±25.36)] μmol/L were lower than those in the control group (P<0.05); Spearman results showed that plasma ox-LDL was positively correlated with FPG, HbA1c and HOMA-IR (P<0.05), while GSH-Px was negatively correlated with FPG, HbA1c and HOMA-IR in the observation group (P< 0.05); the area under curve (AUC) of plasma ox-LDL, GSH-Px single diagnosis and the combined diagnosis was 0.832, 0.816 and 0.887, respectively, the cut-off value of ox-LDL single diagnosis was 679.64 μg/L, the sensitivity and specificity were 71.70% and 82.90%, re-spectively, the cutoff value of GSH-Px single diagnosis was 122.70 μmol/L, the sensitivity and specificity were 88.50% and 69.50%, re-spectively, the sensitivity and specificity of combined diagnosis were 80.50% and 86.70%, which were higher than those of single diag-nosis; multivariate Logistic regression analysis showed that TG, LDL-C and ox-LDL were independent risk factors of T1DM in children (P<0.05), HDL-C and GSH-Px were independent protective factors of T1DM in children (P<0.05).Conclusion The expression of ox-LDL is high and GSH-Px expression is low in plasma of children with T1DM. It is closely related to the occurrence and development ofT1DM, and has a certain diagnostic value. It may provide clinical reference for early diagnosis and disease evaluation of T1DM.
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