The relationships between biological novel biomarkers Lp-PLA2 and CTRP-3 and CVD in patients with type 2 diabetes mellitus

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-06-26 DOI:10.1111/1753-0407.13574

Yanhong Chen, Shixin Wang, Jian Li, Yu Fu, Pengsheng Chen, Xuekui Liu, Jiao Zhang, Li Sun, Rui Zhang, Xiaoli Li, Lingling Liu

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Abstract

Background

Cardiovascular disease (CVD) is recognized as a primary and severe comorbidity in patients with type 2 diabetes mellitus (T2DM) and is also identified as a leading cause of mortality within this population. Consequently, the identification of novel biomarkers for the risk stratification and progression of CVD in individuals with T2DM is of critical importance.

Methods

This retrospective cohort study encompassed 979 patients diagnosed with T2DM, of whom 116 experienced CVD events during the follow-up period. Clinical assessments and comprehensive blood laboratory analyses were conducted. Age- and sex-adjusted Cox proportional hazard regression analysis was utilized to evaluate the association between lipoprotein-associated phospholipase A₂ (Lp-PLA₂), C1q/tumor necrosis factor-related protein 3 (CTRP-3), and the incidence of CVD in T2DM. The diagnostic performance of these biomarkers was assessed through receiver operating characteristic (ROC) curve analysis and the computation of the area under the curve (AUC).

Results

Over a median follow-up of 84 months (interquartile range: 42 [32–54] months), both novel inflammatory markers, Lp-PLA₂ and CTRP-3, and traditional lipid indices, such as low-density lipoprotein cholesterol and apolipoprotein B, exhibited aberrant expression in the CVD-afflicted subset of the T2DM cohort. Age- and sex-adjusted Cox regression analysis delineated that Lp-PLA₂ (hazard ratio [HR] = 1.007 [95% confidence interval {CI}: 1.005–1.009], p < 0.001) and CTRP-3 (HR = 0.943 [95% CI: 0.935–0.954], p < 0.001) were independently associated with the manifestation of CVD in T2DM. ROC curve analysis indicated a substantial predictive capacity for Lp-PLA₂ (AUC = 0.81 [95% CI: 0.77–0.85], p < 0.001) and CTRP-3 (AUC = 0.91 [95% CI: 0.89–0.93], p < 0.001) in forecasting CVD occurrence in T2DM. The combined biomarker approach yielded an AUC of 0.94 (95% CI: 0.93–0.96), p < 0.001, indicating enhanced diagnostic accuracy.

Conclusions

The findings suggest that the biomarkers Lp-PLA₂ and CTRP-3 are dysregulated in patients with T2DM who develop CVD and that each biomarker is independently associated with the occurrence of CVD. The combined assessment of Lp-PLA₂ and CTRP-3 may significantly augment the diagnostic precision for CVD in the T2DM demographic.

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新型生物标记物 Lp-PLA2 和 CTRP-3 与 2 型糖尿病患者心血管疾病之间的关系。

背景：心血管疾病（CVD）被认为是 2 型糖尿病（T2DM）患者的主要和严重并发症，也被认为是导致该人群死亡的主要原因。因此，为 T2DM 患者的心血管疾病风险分层和进展鉴定新型生物标志物至关重要：这项回顾性队列研究涵盖了 979 名确诊为 T2DM 的患者，其中 116 人在随访期间发生了心血管疾病事件。研究人员进行了临床评估和全面的血液实验室分析。利用年龄和性别调整后的 Cox 比例危险回归分析评估了脂蛋白相关磷脂酶 A2（Lp-PLA2）、C1q/肿瘤坏死因子相关蛋白 3（CTRP-3）与 T2DM 患者心血管疾病发病率之间的关系。通过接收者操作特征曲线（ROC）分析和曲线下面积（AUC）计算评估了这些生物标志物的诊断性能：结果：在中位随访 84 个月（四分位数间距：42 [32-54] 个月）期间，新型炎症标志物 Lp-PLA2 和 CTRP-3 以及传统血脂指标（如低密度脂蛋白胆固醇和载脂蛋白 B）在 T2DM 队列中的心血管疾病亚群中均表现出异常表达。经年龄和性别调整后的 Cox 回归分析表明，Lp-PLA2（危险比 [HR] = 1.007 [95%置信区间{CI}：1.005-1.009]，p 2（AUC = 0.81 [95%置信区间：0.77-0.85]，p 结论：T2DM 组群中的低密度脂蛋白胆固醇和脂蛋白 B 等生物标志物在心血管疾病亚组中表现出异常表达：研究结果表明，在发生心血管疾病的 T2DM 患者中，Lp-PLA2 和 CTRP-3 这两种生物标志物会发生失调，而且每种生物标志物都与心血管疾病的发生有独立的关联。联合评估 Lp-PLA2 和 CTRP-3 可显著提高 T2DM 患者心血管疾病的诊断精确度。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.