氧化型低密度脂蛋白对2型糖尿病合并肺结核患者的风险评估价值

doi:10.3969/j.issn.1006-5725.2024.14.016

Abstract

Abstract:

Objective to explore the risk assessment potential of oxLDL in patients with T2DM combined with PTB. Methods A prospective study was conducted， which included 60 cases of simple hyperlipidemia， 100 cases of PTB， 100 cases of T2DM， and 100 cases of T2DM combined with PTB. These patients visited the outpatient department of our center from June 2022 to June 2023. The PTB group， T2DM group， and T2DM combined with PTB group were further divided into subgroups based on normal blood lipids （40 cases） and hyperlipidemia （60 cases）， totaling 360 cases in the case group. Additionally， a control group consisting of 60 healthy individuals was included. The age range for inclusion in the study was between 35 to70 years old. Venous blood samples were collected from each group to detect HbA1c， INS， FSG， CHOL， TG， HDL， LDL， ApoA I and Apo B. OxLDL levels were measured using the ELISA method. Differences in levels between groups were compared. Multivariate logistic regression analysis was applied to assess the association between oxLDL levels and PTB as well as T2DM combined with PTB. Results There were no statistically significant differences in BMI， blood sugar， blood lipids， and insulin resistance between the T2DM hyperlipidemia subgroup and the T2DM combined with PTB hyperlipidemia subgroup. The oxLDL level in the T2DM hypertipidemia subgroup was more than double that of the control group， while the oxLDL level in the subgroup with normal blood lipids was significantly higher than that of the control group. Moreover， both the T2DM combined with PTB hyperlipidemia subgroup and simple hyperlipidemia group exhibited significantly elevated levels of oxLDL compared to the control group； however， there were no statistically significant differences when compared to the PTB hyperlipidemia subgroup. Correlation analysis revealed a significant positive linear correlation between TG and LDL with oxLDL in both the T2DM hyperlipidemia subgroup and the T2DM combined with PTB hyperlipidemia subgroup （R = 0.352， P < 0.05）. Additionally， CHOL and LDL levels in the PTB hyperlipidemia subgroup also showed a significant positive correlation with oxLDL （R = 0.441， P < 0.05）. Multivariate logistic regression analysis indicated that having oxLDL levels more than double that of the control group was an independent risk factor for both PTB and T2DM combined with PTB （P < 0.05）. Conclusion The significantly elevated levels of oxLDL may serve as a potential risk factor for the comorbidity of T2DM and PTB. It is recommended to consider oxLDL levels exceeding twice those of the control group as a clinically meaningful pathological threshold for further assessment.

Key words: type 2 diabetes mellitus, pulmonary tuberculosis, oxidized low density lipoprotein, blood lipid

CLC Number:

R587.1

Jing GUI,Feng WANG,Hui YANG,Yumao CAI,Chuangyue. HONG. Investigation of oxidised low⁃density lipoprotein as a risk assessment indicator in patients with type 2 diabetes mellitus combined with pulmonary tuberculosis[J]. The Journal of Practical Medicine, 2024, 40(14): 1995-2002.

Figures/Tables 5

Tab.1

Basic information of enrolled individuals"

项目	对照组	单纯高脂血症组	PTB		T2DM		T2DM + PTB		F/χ²/H值	P值
项目	对照组	单纯高脂血症组	高脂（-）	高脂（+）	高脂（-）	高脂（+）	高脂（-）	高脂（+）	F/χ²/H值	P值
例数（例）	60	60	40	60	40	60	40	60
年龄（岁)	40.8 ± 7.36	44.8 ± 8.51	46.1 ± 8.93	49.3 ± 10.72	54.59 ± 10.78	56.34 ± 11.52	52.89 ± 10.68	55.69 ± 9.78	16.04	< 0.01
性别									23.492	< 0.01
男［例（%）］	28（46.6）	36（60）	30（75）	45（75）	27（67.5）	48（80）	34（85）	39（65）
女［例（%）］	32（53.3）	24（40）	10（25）	15（25）	13（32.5）	12（20）	6（15）	21（35）
BMI（kg/m²）	21.41 ± 1.47	27.48 ± 2.21	20.98 ± 1.57	24.37 ± 2.37	22.57 ± 2.05	29.67 ± 2.48^a	23.75 ± 1.35	26.3 ± 3.28	257.61	< 0.01
INS（μIU/mL）	9.43 ± 2.23^b	11.48 ± 4.42	9.23 ± 2.2	10.05 ± 3.28	12.94 ± 6.38	14.43 ± 10.54^c	10.71 ± 3.93	12.63 ± 5.81^c	35.36	< 0.01
HOMA-IR	2.02 ± 0.46^f	2.68 ± 1.08	2.13 ± 0.5	2.5 ± 0.85	4.51 ± 2.67ⁱ	5.86 ± 4.4	3.96 ± 2.06ⁱ	5.11 ± 2.69^g	186.19	< 0.01
HbA₁c（%）	5.25 ± 0.29	4.9 ± 0.55	5.32 ± 0.38	5.36 ± 0.41	7.38 ± 1.47ⁱ	7.6 ± 1.79^c	7.92 ± 2.91ⁱ	8.23 ± 3.58^c	261.75	< 0.01
FSG（mmol/L）	4.88 ± 0.53^b	5.29 ± 0.33	5.21 ± 0.46	5.59 ± 0.46	7.81 ± 1.81ⁱ	9.27 ± 3.39^c	8.41 ± 2.78ⁱ	9.36 ± 3.3^c	264.27	< 0.01
TC（mmol/L）	4.69 ± 0.62^b	6.44 ± 0.75^d	4.61 ± 0.69^j	5.97 ± 1.17	4.53 ± 0.66^j	6.21 ± 1.53	4.33 ± 0.75^j	5.69 ± 1.48	159.68	< 0.01
LDL（mmol/L）	2.99 ± 0.37	4.52 ± 0.53^e	3.09 ± 0.5^j	3.97 ± 0.93	3.08 ± 0.46^j	3.98 ± 1.03	2.91 ± 0.62^j	3.73 ± 1.12	28.49	< 0.01
TG（mmol/L）	1.14 ± 0.42^b	3.56 ± 2.29^f	1.13 ± 0.31^j	2.12 ± 1.03	1.21 ± 0.32^j	2.99 ± 2.32	1.15 ± 0.29^j	2.34 ± 1.5	191.32	< 0.01
HDL（mmol/L）	1.43 ± 0.27	1.48 ± 0.27	1.42 ± 0.31^j	1.5 ± 0.33	1.34 ± 0.26^j	1.42 ± 0.4	1.34 ± 0.36^j	1.35 ± 0.39	1.89	> 0.05
ApoA I（g/L）	1.49 ± 0.28	2.46 ± 0.24	1.49 ± 0.24	1.72 ± 0.38	1.76 ± 0.43	4.0 ± 1.06^h	1.55 ± 0.24	2.05 ± 0.38	141.83	< 0.01
Apo B（g/L）	0.79 ± 0.18	0.86 ± 0.31	0.78 ± 0.13	0.9 ± 0.24	1.02 ± 0.18	1.2 ± 0.61^h	0.92 ± 0.16	0.94 ± 0.22	105.54	< 0.01

Tab.1

Fig.1

Fig.2

Fig.3

Tab.2

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指标	例数	未调整混杂因子前			校正混杂因子后
指标	例数	RRR值	95%CI	P 值	RRR值	95%CI	P 值
PTB组
oxLDL	100	0.279	0.168 ~ 0.467	< 0.01	0.254	0.148 ~ 0.438	< 0.01
1 118 ~ 2 362 mU/mL	72	0.138	0.017 ~ 1.115	0.063	0.12	0.014 ~ 1.021	0.052
2 363 ~ 4 724 mU/mL	18	0.044	0.005 ~ 0.369	0.004	0.041	0.005 ~ 0.373	0.005
T2DM + PTB组
oxLDL	100	0.542	0.341 ~ 0.859	0.009	0.561	0.342 ~ 0.919	0.022
1 118 ~ 2 362 mU/mL	62	0.199	0.023 ~ 1.704	0.141	0.179	0.021 ~ 1.542	0.117
2 363 ~ 4 724 mU/mL	29	0.118	0.135 ~ 1.032	0.043	0.081	0.009 ~ 0.722	0.024

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Investigation of oxidised low⁃density lipoprotein as a risk assessment indicator in patients with type 2 diabetes mellitus combined with pulmonary tuberculosis

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