Expression of serum SAA, Gal-3 and HMGB1 in patients with diabetes and coronary heart disease
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摘要: 目的 分析血清淀粉样蛋白酶A(amyloid proteinase A，SAA)、半乳糖凝集素3(galectin-3，Gal-3)、高迁移率族蛋白B1(high mobility group protein B1，HMGB1)在糖尿病合并冠心病患者中的表达及影响因素。方法 选取2021年5月至2022年5月收治的糖尿病合并冠心病患者33例作为合并组，单独糖尿病患者56例作为糖尿病组，单独冠心病患者36例作为冠心病组，并选取同期进行体检的健康人群50例作为健康组。比较4组SAA、Gal-3、HMGB1、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白(HDL-C)、糖基化血红蛋白(GHb)和C反应蛋白(CRP)水平差异，并分析血清SAA、Gal-3、HMGB1在合并组中与FPG、TC、TG、LDL-C、HDL-C、GHb和CRP水平的相关性。结果 血清SAA、Gal-3、HMGB1水平在健康组、冠心病组、糖尿病组和合并组中逐渐上升(P < 0.05)；糖尿病组、冠心病组和合并组中FPG、TC水平，糖尿病组、合并组中GHb水平，冠心病组中TG水平，合并组中CRP水平显著高于健康组(P < 0.05)；糖尿病组中FPG水平，糖尿病和冠心病组中HDL-C水平显著高于合并组(P < 0.05)，冠心病组中FPG水平低于合并组(P < 0.05)；冠心病组中FPG、TG和HDL-C水平低于糖尿病组(P < 0.05)。Spearman相关性分析结果显示，合并组血清SAA、Gal-3、HMGB1水平与血清FPG、TC、TG、LDL-C、HDL-C、GHb和CRP水平呈正相关(P < 0.05)。结论 血清SAA、Gal-3、HMGB1水平在糖尿病合并冠心病患者中会升高，且与糖尿病合并冠心病患者的血糖、血脂指标呈现正相关性，血清SAA、Gal-3、HMGB1水平可以为预测糖尿病合并冠心病患者病情严重程度提供参考。Abstract: Objective To analyze the expression of serum SAA, Gal-3 and HMGB1 in the patients with diabetes complicated with coronary heart disease and their influencing factors.Methods A total of 33 patients with diabetes combined with coronary heart disease admitted to our hospital from May 2021 to May 2022 were selected as the diabetes combined with coronary heart disease group, 56 patients with diabetes alone as the diabetes group, 36 patients with coronary heart disease alone as the coronary heart disease group, and 50 healthy people who came to our hospital for physical examination in the same period were selected as the healthy group. The levels of serum amyloid proteinase A(SAA), galectin 3(Gal-3), high mobility group protein B1(HMGB1), fasting blood glucose(FPG), total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein(HDL-C), glycosylated hemoglobin(GHB) and C-reactive protein(CRP) in the 4 groups were compared, and the relationship between serum SAA, Gal-3, HMGB1 and FPG, TC, TG, LDL-C, HDL-C, GHb and CRP levels was analyzed in the diabetes combined with coronary heart disease group.Results The serum SAA level gradually increased in the health group, coronary heart disease group, diabetes group and combined group(P < 0.05), while the serum Gal-3 and HMGB1 levels gradually increased in the health group, diabetes group, coronary heart disease group and diabetes combined coronary heart disease group(P < 0.05), the FPG and TC levels in diabetes group, coronary heart disease group and combined group, the GHb level in diabetes group, diabetes combined coronary heart disease group, and the TG level in coronary heart disease group, the CRP level in diabetes with coronary heart disease group was significantly higher than that in healthy group(P < 0.05); FPG level in diabetes group, HDL-C level in diabetes and coronary heart disease group were significantly higher than those in diabetes with coronary heart disease group(P < 0.05), and FPG level in coronary heart disease group was lower than that in diabetes with coronary heart disease group(P < 0.05); the levels of FPG, TG and HDL-C in coronary heart disease group were lower than those in diabetes group(P < 0.05). Spearman correlation analysis showed that serum levels of SAA, Gal-3, HMGB1 were positively correlated with serum levels of FPG, TC, TG, LDL-C, HDL-C, GHb and CRP in patients with diabetes and coronary heart disease(P < 0.05).Conclusion Serum levels of SAA, Gal-3 and HMGB1 will increase in the patients with diabetes and coronary heart disease, and show a good positive correlation with blood glucose and lipid indicators in the patients with diabetes and coronary heart disease. Serum levels of SAA, Gal-3 and HMGB1 can provide a reference for predicting the severity of disease in patients with diabetes and coronary heart disease.
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表 1 4组患者一般资料
组别 例数 男/女/例 年龄/岁 体重指数/(kg/m2) 健康组 50 28/22 67.70±5.76 23.91±3.36 糖尿病组 56 32/24 67.39±5.79 23.89±3.40 冠心病组 36 21/15 67.36±5.77 23.67±3.75 合并组 33 19/14 67.91±5.67 23.39±3.79 t/χ2 0.050 0.080 0.183 P 0.997 0.971 0.908 
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表 2 4组SAA、Gal-3、HMGB1水平比较
X±S 指标 健康组(50例) 糖尿病组(56例) 冠心病组(36例) 合并组(33例) SAA/(μg/mL) 4.94±1.07 20.91±6.361)2) 11.19±3.541)2)3) 26.66±7.231) Gal-3/(ng/mL) 1.14±0.21 2.70±0.331)2) 5.91±0.641)2)3) 10.36±2.031) HMGB1/(μg/L) 1.24±0.41 3.50±1.531)2) 5.86±0.781)2)3) 9.81±1.041) 与健康组比较，1) P < 0.05；与合并组比较，2) P < 0.05；与糖尿病组比较，3) P < 0.05。
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表 3 4组血脂和CRP水平比较
X±S 指标 健康组(50例) 糖尿病组(56例) 冠心病组(36例) 合并组(33例) FPG/(mmol/L) 5.20±0.61 10.94±1.071)2) 5.64±0.711)2)3) 9.84±1.711) TC/(mmol/L) 3.80±0.70 4.68±0.761) 4.70±0.831) 4.66±0.731) TG/(mmol/L) 1.19±0.10 1.19±0.14 1.11±0.141)3) 1.16±0.18 LDL-C/(mmol/L) 2.89±0.79 2.91±1.06 3.14±0.91 3.21±1.16 HDL-C/(mmol/L) 1.16±0.38 1.16±0.332) 1.06±0.332)3) 0.95±0.341) GHb/% 5.46±0.43 9.59±2.641) 5.50±2.53 9.39±2.741) CRP/(mg/L) 3.20±0.91 3.39±1.09 3.39±0.89 3.76±1.281) 与健康组比较，1) P < 0.05；与合并组比较，2) P < 0.05；与糖尿病组比较，3) P < 0.05。
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表 4 相关性分析
指标 FPG TC TG LDL-C HDL-C GHb CRP SAA r 0.620 0.612 0.511 0.483 0.704 0.393 0.517 P < 0.001 < 0.001 0.002 0.004 < 0.001 0.024 0.002 Gal-3 r 0.587 0.636 0.528 0.564 0.752 0.491 0.821 P < 0.001 < 0.001 0.002 0.001 < 0.001 0.004 < 0.001 HMGB1 r 0.714 0.755 0.679 0.606 0.776 0.568 0.729 P < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 0.001 < 0.001
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