标题：2型糖尿病患者血清Sestrin2、KLF2水平与颈动脉粥样硬化的相关性研究

      作者：王前，王翼华    南阳市第一人民医院内分泌科，河南 南阳 473000

      卷次： 2023年34卷23期

      【摘要】 目的 检测2型糖尿病(T2DM)患者血清Sestrin2、锌指转录因子2 (KLF2)水平，并分析其与颈动脉粥样硬化(CAS)的关系。方法 选择 2020年 1月至 2022年 1月期间南阳市第一人民医院内分泌科收治的 140例T2DM患者作为研究对象，根据超声诊断结果分为合并CAS (T2C)组79例和单纯T2DM (T2)组61例，并依据颈动脉内膜中层厚度(CIMT)将T2C组患者分为初级增厚组41例和动脉斑块组38例。同期选取70例体检健康者作为对照组。采用酶联免疫吸附法检测所有受检者的血清 Sestrin2、KLF2表达水平，采用 Pearson相关分析 Sestrin2、KLF2与炎性因子和糖脂代谢指标的相关性，采用Logistic回归分析T2DM患者合并CAS的影响因素，采用受试者工作特征曲线(ROC)分析血清Sestrin2、KLF2水平对T2DM患者合并CAS的预测价值。结果 与对照组比较，T2C组和T2组患者的血清Sestrin2、KLF2水平较低，且T2C组明显低于T2组，差异均有统计学意义(P<0.05)；动脉斑块组患者的血清 Sestrin2、KLF2水平分别为 (2.680±0.850) ng/mL、(1.740±0.450) pg/mL，明显低于初级增厚组的(3.610±1.180) ng/mL、(2.380±0.780) pg/mL，差异均具有统计学意义(P<0.05)；经 Pearson相关分析结果显示，血清KLF2、Sestrin2与 IL-6、IL-1β、VEGF、TNF-α、LDL-C、HbA1c和Hcy均呈负相关(P<0.05)，血清KLF2与Sestrin2正相关(P<0.05)；经Logistic回归分析结果显示，病程、IL-6、VEGF、HbA1c、Sestrin2、KLF2均为T2DM患者发生CAS的影响因素(P<0.05)；经 ROC分析结果显示，Sestrin2、KLF2两者联合诊断 T2DM患者发生 CAS的曲线下面积(AUC)优于Sestrin2、KLF2单独诊断(Z两者联合-Sestrin2=3.012，P<0.05；Z两者联合-KLF2=4.133，P<0.05)。结论 T2DM合并CAS患者血清Sestrin2、KLF2水平明显较低，且与患者动脉硬化程度关系密切。
      【关键词】 2型糖尿病；颈动脉粥样硬化；Sestrin2；锌指转录因子2；相关性
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2023）23—3366—06

Relationship between serum Sestrin2, KLF2 levels and carotid atherosclerosis in patients with type 2 diabetesmellitus.
WANG Qian, WANG Yi-hua. Department of Endocrinology, Nanyang First People's Hospital, Nanyang 473000,Henan, CHINA
【Abstract】 Objective To measure the serum levels of Sestrin 2 and Krüppel-like factor 2 (KLF2) in patientswith type 2 diabetes mellitus (T2DM), and analyze their relationship with carotid atherosclerosis (CAS).Methods A to-tal of 140 T2DM patients admitted to the Department of Endocrinology, Nanyang First People's Hospital from January2020 to January 2022 were selected as the study subjects. They were divided into a T2DM combined with CAS group(T2C group, 79 cases) and a simple T2DM group (T2 group, 61 cases) based on ultrasound diagnosis results. Patients inthe T2C group were divided into a primary thickening group (41 cases) and an arterial plaque group (38 cases) based oncarotid intima media thickness (CIMT). Meantime, 70 healthy individuals were included as the control (CK) group. En-zyme-linked immunosorbent assay was applied to detect the expression levels of serum Sestin2 and KLF2. Pearson corre-lation was applied to analyze the correlation between Sestin2, KLF2 and inflammatory factors, glycolipid metabolism in-dicators. Logistic regression was applied to analyze the influencing factors of CAS in T2DM patients. Receiver operat-ing characteristic (ROC) curve was applied to analyze the predictive value of serum levels of Sestin2 and KLF2 inT2DM patients with CAS. Results Compared with the control group, the serum levels of Sestrin2 and KLF2 in theT2C and T2 groups were significantly lower, and the levels in T2C group was significantly lower than those in the T2group, with statistically significant differences (P<0.05). The serum levels of Sestrin2 and KLF2 in the arterial plaquegroup were (2.680±0.850) ng/mL and (1.740±0.450) pg/mL, respectively, significantly lower than (3.610±1.180) ng/mLand (2.380±0.780) pg/mL in the primary thickening group, with statistically significant differences (P<0.05). Accordingto Pearson correlation analysis, serum KLF2, Sestrin2 were negatively correlated with IL-6, IL-1 β, VEGF, TNF-α,LDL-C, HbA1c, and Hcy (P<0.05), while serum KLF2 was positively correlated with Sestrin2 (P<0.05). The results oflogistic regression analysis showed that the course of disease, IL-6, VEGF, HbA1c, Sestrin2, and KLF2 were all influ-encing factors for the occurrence of CAS in T2DM patients (P<0.05). The results of ROC analysis showed that the areaunder the curve (AUC) of the combined detection of Sestrin2 and KLF2 in predicting CAS in T2DM patients wasbetter than that of the single detection of Sestrin2 or KLF2 (Zcombined -Sestrin2=3.012, P<0.05; Zcombined-Sestrin2=4.133，P<0.05). Conclusion The serum levels of Sestin2 and KLF2 in patients with T2DM and CAS are significantly lower, andthey are closely related to the degree of arteriosclerosis in patients.
      【Key words】 Type 2 diabetes mellitus; Carotid atherosclerosis; Sestrin2; Krüppel-like factor 2; Relationship