血清LPA、AngII及β2-MG在老年2型糖尿病患者病情监控中的作用及其与胰岛素抵抗的相关性分析

摘要 目的：分析血清溶血磷脂酸（LPA）、血管紧张素II（AngII）及β2-微球蛋白（β2-MG）在老年2型糖尿病患者病情监控中的作用及其与胰岛素抵抗的相关性。方法：选择我院自2020年1月至2023年6月收治的106例老年2型糖尿病患者作为观察组，其中34例患者并发肾病（糖尿病肾病组），72例患者不并发肾病（单纯糖尿病组）；另选106例健康体检者作为对照组。检测所有入选者血清LPA、AngII及β2-MG表达水平，使用多因素Logistic 回归分析血清LPA、AngII及β2-MG与老年2型糖尿病患者并发肾病的关系，Pearson相关性分析血清LPA、AngII及β2-MG表达水平与空腹血糖（FPG）、餐后2 h血糖（2hPG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-β）的关系。结果：观察组血清LPA、AngII、β2-MG表达水平均高于对照组（P＜0.05）；糖尿病肾病组血清LPA、AngII、β2-MG表达水平均明显高于单纯糖尿病组（P＜0.05）；经多因素Logistic 回归分析，血清LPA、AngII及β2-MG均是老年2型糖尿病患者并发肾病的独立预测因素（P＜0.05）；观察组FPG、2hPG、FINS、HbA1c表达水平均高于对照组，HOMA-IR大于对照组，HOMA-β小于对照组（P＜0.05）；经Pearson相关性分析，老年2型糖尿病患者血清LPA、AngII及β2-MG均与FPG、2hPG、FINS、HbA1c、HOMA-IR呈正相关（P＜0.05），与HOMA-β呈负相关（P＜0.05）。结论：血清LPA、AngII及?茁2-MG表达水平升高对老年2型糖尿病患者的病情监控具有一定作用，且均与胰岛素抵抗程度密切相关，值得进一步研究应用。

The Role of Serum LPA, AngII and β2-MG in Disease Monitoring in Elderly Patients with Type 2 Diabetes and Their Correlation with Insulin Resistance

ABSTRACT Objective: To analyze the role of serum lysophosphatidylic acid (LPA),angiotensin II(AngII) and β2-microglobulin (β2-MG) in disease monitoring in elderly patients with type 2 diabetes mellitus and their correlation with insulin resistance. Methods: 106 elderly patients with type 2 diabetes admitted to our hospital from January 2020 to June 2023 were selected as the observation group, of which 34 patients were complicated with kidney disease (diabetic nephropathy group) and 72 patients were not complicated with kidney disease (simple diabetes group). Another 106 healthy subjects were selected as control group. The expression levels of serum LPA, AngII and β2-MG in all participants were detected, and the relationship between serum LPA, AngII and β2-MG and nephropathy in elderly patients with type 2 diabetes was analyzed by multivariate Logistic regression. Pearson correlation was used to analyze the relationship between serum LPA, AngII and β2-MG expression levels and fasting blood glucose (FPG), 2 h postmeal blood glucose (2hPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR) and islet beta cell function index (HOMA-β). Results: The levels of serum LPA, AngII and β2-MG in observation group were higher than those in control group (P<0.05). The expression levels of serum LPA, AngII and β2-MG in diabetic nephropathy group were significantly higher than those in simple diabetic group (P<0.05). Multivariate Logistic regression analysis showed that serum LPA, AngII and β2-MG were independent predictors of nephropathy in elderly patients with type 2 diabetes(P<0.05). The expression levels of FPG, 2hPG, FINS and HbA1c in observation group were higher than those in control group, HOMA-IR was higher than that in control group, HOMA-β was lower than that in control group (P<0.05). By Pearson correlation analysis, serum LPA, AngII and β2-MG in elderly patients with type 2 diabetes were positively correlated with FPG, 2hPG, FINS, HbA1c and HOMA-IR (P<0.05), and negatively correlated with HOMA-β (P<0.05). Conclusion: The elevated levels of serum LPA, AngII and β2-MG have a certain effect on the disease monitoring of elderly patients with type 2 diabetes,and are closely related to the degree of insulin resistance, which is worthy of further study and application.