摘要目的 探讨糖化白蛋白(GA)、同型半胱氨酸(Hcy)水平与糖尿病合并心血管疾病的关系.方法 选取天津医科大学代谢病医院2015年5月至2016年5月住院的2型糖尿病患者358例作为研究对象.根据是否合并心血管疾病及症状分为糖尿病合并心血管疾病组(202例)和糖尿病无心血管疾病组(156例),同时以健康查体者152名作为正常对照组.比较各组间一般生化指标及GA、Hcy的含量,并进行受试者工作特征(ROC)曲线分析,确定相应的临床诊断界值.结果 糖尿病合并心血管疾病组GA(F=12.863,P＜0.05)、Hcy(F=9.792,P＜0.05)水平显著高于糖尿病无心血管疾病组和正常对照组;且糖尿病合并心血管疾病组的GA与Hcy水平呈正相关(r=0.946,P ＜0.05).血清GA诊断糖尿病合并心血管疾病的ROC曲线下面积为0.865 2,敏感性为90.38％,特异性为56.28％ (95％ CI:0.824 2～0.906 2),Youde指数最大点对应的诊断界值为17.36％;Hcy诊断糖尿病合并心血管疾病组的ROC曲线下面积为0.910 3,敏感性为92.75％,特异性为75.89％(95％ CI:0.878 1～0.942 6),Youde指数最大点对应的诊断界值为13.25 μmoL/L.结论 血清GA、Hcy与糖尿病心血管疾病相关,二者联合检测可以作为糖尿病心血管疾病的早期预警指标.

abstractsObjective To investigate the relationship between serum glycated albumin(GA),homocyste(Hcy) and diabetic cardiovascular disease.Methods A total of 358 patients with type 2 diabetes mellitus in the Metabolic Disease Hospital of Tianjin Medical University from May 2015 to May 2016 were enrolled in this study.According to their status of cardiovascular disease and symptoms,the patients were divided into diabetes with cardiovascular disease group (n =202) and diabetes without cardiovascular disease group (n =156).Another 152 healthy person were choosed as normal control group.The levels of general biochemical indexes,GA and Hcy were compared,and the receiver operating characteristic (ROC) curve analysis was used to determine the clinical diagnostic threshold for cardiovascular disease in diabetes.Results The levels of GA (F =12.863,P ＜ 0.05) and Hcy (F =9.792,P ＜ 0.05) in diabetes with cardiovascular group were significantly higher than those in diabetes without cardiovascular disease group and normal control group.And the level of GA was positively correlated with Hcy level in diabetes with cardiovascular group(r =0.946,P ＜ 0.05).The area under the ROC curve in the diagnosis of diabetic cardiovascular disease for serum GA was 0.865 2;the sensitivity was 90.38％ and the specificity was 56.28％ (95％ CI:0.824 2-0.906 2).The diagnostic threshold of GA was 17.36％ with a maximum value of Youde index.The area under the ROC curve in the diagnosis of diabetes with cardiovascular disease for serum Hcy was 0.910 3;the sensitivity was 92.75％ and the specificity was 75.89％ (95％ CI:0.878 1-0.942 6).The diagnostic threshold of Hcy was 13.25 μmol/L with a maximum value of Youde index.Conclusions Serum GA and Hcy are correlated with diabetic cardiovascular disease.The combination of GA and Hcy can be used as early predictors in diabetic cardiovascular disease.