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目的探讨血过氧化物酶体增殖因子活化受体γ(PPARγ)、胱抑素C和晚期氧化蛋白产物(AOPP)对老年2型糖尿病(T2DM)患者动脉粥样硬化(AS)的诊断价值。方法 T2DM伴AS患者80例,年龄≥75岁。根据肱-踝动脉脉搏波速度(baPWV)将80例患者均分为两组。轻度AS组baPWV 1400~2000cm/s,重度AS组baPWV>2000cm/s。应用RT-PCR检测患者血浆PPARγ基因表达,ELISA双抗体夹心法测定血清AOPP水平,免疫比浊法测定血清胱抑素C水平。结果重度AS组血浆PPARγ表达高于轻度AS组(P<0.01)。两组血清胱抑素C与AOPP水平差异无统计学意义(P>0.05)。PPARγ对重度AS具有较高的诊断价值(AUC=0.850)。联合检测PPARγ、胱抑素C和AOPP对判断AS有更高的诊断价值[AUC=0.961,95%CI(0.916~1.000),灵敏度=0.975]。结论血PPARγ、AOPP及胱抑素C与老年T2DM患者AS密切相关。
Objective To investigate the diagnostic value of peroxisome proliferator-activated receptor γ (PPARγ), cystatin C and advanced oxidation protein (AOPP) in the diagnosis of atherosclerosis (AS) in elderly patients with type 2 diabetes mellitus (T2DM). Methods T2DM with AS patients 80 cases, age ≥ 75 years. Eighty patients were divided into two groups based on brachial-ankle pulse wave velocity (baPWV). The baPWV of mild AS group was 1400 ~ 2000cm / s and that of severe AS group was> 2000cm / s. The expression of plasma PPARγ gene was detected by RT-PCR, serum AOPP level by ELISA and serum cystatin C level by immunoturbidimetry. Results The expression of PPARγ in severe AS group was higher than that in mild AS group (P <0.01). There was no significant difference in serum cystatin C and AOPP levels between the two groups (P> 0.05). PPARγ has a high diagnostic value for severe AS (AUC = 0.850). The combined detection of PPARγ, cystatin C and AOPP has a higher diagnostic value for judging AS [AUC = 0.961, 95% CI (0.916-1.000), sensitivity = 0.975]. Conclusions Blood PPARγ, AOPP and cystatin C are closely related to AS in elderly patients with T2DM.