血清YKL-40水平與糖尿病足病的相關性探討
發(fā)布時間：2018-11-01 16:54
【摘要】：目的幾丁質酶3樣蛋白1(YKL-40)是近些年來新發(fā)現(xiàn)的一種炎癥因子,參與了炎癥、血管病變和動脈粥樣硬化的發(fā)生、發(fā)展過程。本試驗的目的在于探討血清YKL-40水平與糖尿病足病的相關性。方法按照1999年WHO糖尿病診斷標準,選取2015年3月至2016年10月在華北理工大學附屬開灤總醫(yī)院內分泌科住院的糖尿病患者121例,按是否患有糖尿病足病將所有受試對象分為糖尿病足病組(DF組,69例)和2型糖尿病組(DM組,52例)。按足部是否存在缺血分為2個亞組:缺血組36例和非缺血組33例。記錄所有受試對象的一般臨床資料及DF組患者的Wagner分級情況,采用酶聯(lián)免疫吸附雙抗體夾心法測定所有受試對象的血清YKL-40水平,并測定生化指標、超敏C反應蛋白(hs-CRP)以及糖化血紅蛋白(Hb A1c)水平。對血清YKL-40水平在各組間的差異及其與糖尿病足病之間的關系進行分析。結果1 DF組和DM組的比較:與DM組相比,DF組的病程、空腹血糖(FPG)、hs-CRP及血清YKL-40水平均明顯升高(均P0.05),差異有統(tǒng)計學意義;DF組的血紅蛋白(Hb)和總膽紅素均明顯降低(均P0.05),差異具有統(tǒng)計學意義。血清YKL-40濃度在110.16ng/ml以上的糖尿病患者發(fā)生DF的相對危險度(OR值)為13.537,說明DM患者血清YKL-40濃度在110.16ng/ml以上時,患DF的風險是YKL-40在110.16ng/ml以下的13.537倍。進一步以糖尿病是否合并DF為因變量,將DF組和DM組之間具有顯著性差異的指標作為協(xié)變量引入多因素Logistic回歸模型中進行分析。結果顯示,YKL-40是DF的危險因素。2缺血組和非缺血組的比較:與非缺血組相比,缺血組的病程、FPG、hs-CRP及血清YKL-40水平均明顯升高(均P0.05),差異具有統(tǒng)計學意義;缺血組的Hb、總膽紅素及HDL均明顯降低(均P0.05),差異具有統(tǒng)計學意義;血清YKL-40濃度在123.90ng/ml以上的DF患者發(fā)生缺血性糖尿病足病的相對危險度(OR值)為3.538,說明DF患者血清YKL-40濃度在123.90ng/ml以上時,患缺血性糖尿病足病的風險是YKL-40在123.90ng/ml以下的3.538倍。進一步以DF是否合并缺血為因變量,以缺血組和非缺血組兩組間具有顯著差異的指標為協(xié)變量引入多因素Logistic回歸模型進行分析,結果顯示,YKL-40為缺血性糖尿病足病的危險因素。結論1血清YKL-40水平與糖尿病足病呈正相關,參與了糖尿病足病的發(fā)生和發(fā)展過程。2血清YKL-40水平與糖尿病足病足部缺血程度呈正相關。
[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.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.2
本文編號：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.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.2
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