Relationship between alpha 2-Heremans-Schmid glycoprotein to adiponectin ratio and type 2 diabetes mellitus complicated with metabolic syndrome

doi:10.3969/j.issn.1673-8640.2020.05.004

Abstract

Abstract:

Objective To investigate the relationship between alpha 2-Heremans-Schmid glycoprotein（AHSG） to adiponectin（APN） ratio and type 2 diabetes mellitus（T2DM） complicated with metabolic syndrome（MS）. Methods A total of 130 newly diagnosed patients with T2DM were enrolled,including 61 patients with only T2DM,69 patients with T2DM complicated with MS. A total of 60 healthy subjects were enrolled as control group. The general data of all the subjects were collected. Fasting plasma glucose,total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,C-reactive protein（CRP）,fasting insulin（FINS）,AHSG and APN levels were determined,and homeostasis model assessment of insulin resistance（HOMA-IR） index and AHSG/APN ratio was calculated. Spearman rank correlation analysis was used to analyze the relationships among various parameters. Logistic regression analysis was used to evaluate the risk factors of T2DM complicated with MS. Receiver operating characteristic（ROC） curve analysis was performed to evaluate the auxiliary diagnostic values of various parameters for T2DM complicated with MS. Results AHSG and AHSG/APN ratio increased gradually from control group,T2DM group to T2DM complicated with MS group,whereas APN decreased gradually among them（P<0.05）. Spearman rank correlation analysis showed that AHSG was positively correlated with waistline,fasting plasma glucose,TG,LDL-C,HOMA-IR,CRP and AHSG/APN ratio（P<0.01）,and it was negatively correlated with APN（P<0.01）. APN was negatively correlated with waistline,body mass index（BMI）,systolic and diastolic blood pressures,TC,AHSG and AHSG/APN ratio（P<0.05,P<0.01）,and it was positively correlated with HDL-C（P<0.05）. AHSG/APN ratio was correlated with all the parameters（P<0.05,P<0.01） except age（P>0.05）. Logistic regression analysis showed that only AHSG/APN ratio was the risk factor for MS in T2DM patients after adjusting for confounding factors [odds ratio（OR）=1.051,95% confidence interval（CI） 1.015-1.088,P<0.01],and APN was a protective factor of MS（OR=0.758,95%CI 0.566-0.978,P=0.047）. ROC curve analysis indicated the areas under curves（AUC） of AHSG,APN and AHSG/APN ratio in auxiliary diagnosis of MS were 0.692,0.730 and 0.806,respectively,and the diagnostic performance of AHSG/APN ratio was superior to either AHSG or APN. Conclusions AHSG/APN ratio would reflect the metabolic disorder and the risk of MS in T2DM patients,and it could have a auxiliary diagnostic value for T2DM complicated with MS.

Key words: Alpha 2-Heremans-Schmid glycoprotein, Adiponectin, Type 2 diabetes mellitus, Metabolic syndrome

CLC Number:

R446.1

ZHOU Zhongwei, JU Huixiang, JIN Hao, CHEN Hongmei, SUN Mingzhong. Relationship between alpha 2-Heremans-Schmid glycoprotein to adiponectin ratio and type 2 diabetes mellitus complicated with metabolic syndrome[J]. Laboratory Medicine, 2020, 35(5): 414-419.

Figures/Tables 5

References 14

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组别	例数	年龄/岁	性别/例		BMI/（kg/m²）	腰围/cm	收缩压/kPa
组别	例数	年龄/岁	男	女	BMI/（kg/m²）	腰围/cm	收缩压/kPa
T2DM合并MS组	69	51.32±10.16	33	36	26.81±2.69^*#	93.36±8.77^*#	18.97±2.48^*#
单纯T2DM组	61	50.05±9.81	32	29	23.19±2.46	84.22±8.23	18.06±2.34^*
正常对照组	60	49.92±8.75	33	27	22.78±2.85	82.55±7.85	16.55±1.63
组别	舒张压/kPa	空腹血糖/ （mmol/L）	TC/（mmol/L）		TG/（mmol/L）	HDL-C/（mmol/L）	LDL-C/ （mmol/L）
T2DM合并MS组	11.90±1.32^*#	9.08±1.95^*	5.73±1.14^*#		2.68±1.59^*#	1.07±0.21^*	3.20±0.89^*
单纯T2DM组	11.12±1.19^*	8.75±1.84^*	5.21±0.95^*		1.88±1.06^*	1.21±0.33^*	3.12±0.82^*
正常对照组	10.04±1.25	5.13±0.72	4.82±0.84		1.33±0.65	1.46±0.38	2.48±0.69
组别	FINS/ （μIU/mL）	HOMA-IR	CRP/（mg/L）		AHSG/（mg/L）	APN/ （mg/L）	AHSG/APN比值
T2DM合并MS组	19.63±3.92^*#	4.85（3.83~6.51）^*#	4.92（3.78~6.95）^*#		329.8（288.3~382.2）^*#	7.6（6.1~8.3）^*#	43.7（35.9~50.9）^*#
单纯T2DM组	14.06±3.64^*	4.02（2.96~5.04）^*	4.32（3.20~5.77）^*		303.5（248.8~347.7）^*	8.1（7.2~9.2）^*	34.5（28.7~44.2）^*
正常对照组	9.19±2.52	2.13（1.45~2.61）	1.77（1.12~2.58）		249.6（196.2~288.5）	10.0（8.5~10.8）	26.8（17.8~32.5）

组别	例数	年龄/岁	性别/例		BMI/（kg/m²）	腰围/cm	收缩压/kPa
组别	例数	年龄/岁	男	女	BMI/（kg/m²）	腰围/cm	收缩压/kPa
T2DM合并MS组	69	51.32±10.16	33	36	26.81±2.69^*#	93.36±8.77^*#	18.97±2.48^*#
单纯T2DM组	61	50.05±9.81	32	29	23.19±2.46	84.22±8.23	18.06±2.34^*
正常对照组	60	49.92±8.75	33	27	22.78±2.85	82.55±7.85	16.55±1.63
组别	舒张压/kPa	空腹血糖/ （mmol/L）	TC/（mmol/L）		TG/（mmol/L）	HDL-C/（mmol/L）	LDL-C/ （mmol/L）
T2DM合并MS组	11.90±1.32^*#	9.08±1.95^*	5.73±1.14^*#		2.68±1.59^*#	1.07±0.21^*	3.20±0.89^*
单纯T2DM组	11.12±1.19^*	8.75±1.84^*	5.21±0.95^*		1.88±1.06^*	1.21±0.33^*	3.12±0.82^*
正常对照组	10.04±1.25	5.13±0.72	4.82±0.84		1.33±0.65	1.46±0.38	2.48±0.69
组别	FINS/ （μIU/mL）	HOMA-IR	CRP/（mg/L）		AHSG/（mg/L）	APN/ （mg/L）	AHSG/APN比值
T2DM合并MS组	19.63±3.92^*#	4.85（3.83~6.51）^*#	4.92（3.78~6.95）^*#		329.8（288.3~382.2）^*#	7.6（6.1~8.3）^*#	43.7（35.9~50.9）^*#
单纯T2DM组	14.06±3.64^*	4.02（2.96~5.04）^*	4.32（3.20~5.77）^*		303.5（248.8~347.7）^*	8.1（7.2~9.2）^*	34.5（28.7~44.2）^*
正常对照组	9.19±2.52	2.13（1.45~2.61）	1.77（1.12~2.58）		249.6（196.2~288.5）	10.0（8.5~10.8）	26.8（17.8~32.5）

项目	AHSG		APN		AHSG/APN比值
项目	r值	P值	r值	P值	r值	P值
年龄	-0.037	0.678	0.134	0.130	-0.071	0.421
腰围	0.433	<0.01	-0.219	0.012	0.466	<0.01
BMI	0.115	0.194	-0.187	0.033	0.174	0.048
收缩压	0.157	0.074	-0.228	<0.01	0.243	<0.01
舒张压	0.083	0.350	-0.206	0.018	0.175	0.047
空腹血糖	0.277	<0.01	-0.160	0.069	0.317	<0.01
TC	0.171	0.051	-0.191	0.029	0.216	0.014
TG	0.339	<0.01	-0.150	0.089	0.345	<0.01
HDL-C	- 0.130	0.140	0.222	0.011	-0.177	0.044
LDL-C	0.293	<0.01	-0.097	0.272	0.337	<0.01
HOMA-IR	0.327	<0.01	-0.146	0.098	0.355	<0.01
CRP	0.371	<0.01	-0.148	0.092	0.376	<0.01
AHSG			-0.244	<0.01	0.907	<0.01
APN	-0.244	<0.01			-0.565	<0.01
AHSG/APN比值	0.907	<0.01	-0.565	<0.01

项目	AHSG		APN		AHSG/APN比值
项目	r值	P值	r值	P值	r值	P值
年龄	-0.037	0.678	0.134	0.130	-0.071	0.421
腰围	0.433	<0.01	-0.219	0.012	0.466	<0.01
BMI	0.115	0.194	-0.187	0.033	0.174	0.048
收缩压	0.157	0.074	-0.228	<0.01	0.243	<0.01
舒张压	0.083	0.350	-0.206	0.018	0.175	0.047
空腹血糖	0.277	<0.01	-0.160	0.069	0.317	<0.01
TC	0.171	0.051	-0.191	0.029	0.216	0.014
TG	0.339	<0.01	-0.150	0.089	0.345	<0.01
HDL-C	- 0.130	0.140	0.222	0.011	-0.177	0.044
LDL-C	0.293	<0.01	-0.097	0.272	0.337	<0.01
HOMA-IR	0.327	<0.01	-0.146	0.098	0.355	<0.01
CRP	0.371	<0.01	-0.148	0.092	0.376	<0.01
AHSG			-0.244	<0.01	0.907	<0.01
APN	-0.244	<0.01			-0.565	<0.01
AHSG/APN比值	0.907	<0.01	-0.565	<0.01

项目	未校正混杂因素		校正混杂因素后
项目	OR值（95%CI）	P值	OR值（95%CI）	P值
AHSG	1.007（1.004~1.010）	<0.01	1.004（1.000~1.008）	0.081
APN	0.586（0.443~0.776）	<0.01	0.758（0.566~0.978）	0.047
AHSG/APN比值	1.070（1.040~1.102）	<0.01	1.051（1.015~1.088）	<0.01