| Objective:To study whether serum osteopontin(OPN)and osteoprotegerin(OPG)can be used as biological markers to assist in the assessment of the condition and risk of type 2 diabetes mellitus(T2DM)with coronary atherosclerotic disease(CAD);and to evaluate the correlation between the levels of serum OPN and OPG with the severity of coronary artery lesions in T2DM patients.Methods:A total of 100 patients diagnosed or suspected CAD complicated with T2DM and underwent coronary angiography(CAG)were enrolled from November 2019 to December 2020.According to CAG results,the patients diagnosed with CAD were assigned to the study group(n=60),and the patients without CAD were assigned to the control group(n=40).Clinical data of each patient were recorded:gender,age,height,weight,heart rate at admission,systolic blood pressure at admission,diastolic blood pressure at admission,duration of diabetes,history of hypertension,family history of CAD,history of drinking,history of smoking,and body mass index(BMI)was calculated.Some blood routine and biochemical indicators were collected:triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),fasting plasma glucose(FPG),glycosylated hemoglobin A1c(Hb A1c),creatinine(Cr),blood urea nitrogen(BUN),Uric acid(UA),white blood cell(WBC).Enzyme linked immunosorbent assay(ELISA)was used to measure OPN and OPG levels in serum.Two physicians with rich interventional experience in our department evaluated the lesion site and stenosis degree of coronary arterythe according to visual method,and used Gensini scoring systemto to evaluate the severity of coronary artery lesions.We compared the Clinical baseline data,serum OPN and OPG between the two groups and developd the receiver operating characteristic curve(ROC)to evaluate the predictive value of serum OPN,OPG in T2DM with CAD,and to determine the optimal cutoff value;Logistic regression was used to analyze whether serum OPN and OPG were risk factors for T2DM with CAD;Spearman correlation analysis was used to analyze the correlation between serum OPN,OPG and Gensini scores in T2DM patients.Results:1 Compared with control group,the proportion of smoking patients and hypertension patients in study group were higher,they are shown as56.66%(34/60)vs 30.00%(12/40);73.33%(44/60)vs 52.50%(21/40),the difference was statistically significant(all P<0.05).Compared with control group,The duration of diabetes,FPG,BMI,Hb A1c,Cr,LDL-C,Gensini score,serum OPN and OPG in the study group were all higher,they are shown as 9.00(4.00,13.00)years vs 5.50(3.00,10.00)years;11.65(8.63,14.55)mmol/L vs 8.53(6.48,12.55)mmol/L;(29.14±3.23)kg/m~2vs(26.58±3.54)kg/m~2;7.80(6.90,9.10)mmol/L vs 6.80(6.13,7.59)mmol/L;62.05(50.19,71.70)umol/L vs 53.25(47.25,66.05)umol/L;2.36(1.88,2.85)mmol/L vs2.06(1.62,2.48)mmol/L;47.50(26.00,85.50)scores vs3.50(0.50,10.00)scores;13.076(8.433,23.552)ng/m L vs 6.367(4.605,9.048)ng/m L;0.437(0.300,0.630)ng/m L vs0.299(0.196,0.399)ng/m L,the difference was statistically significant(all P<0.05).2 The area under the curve of serum OPN in the prediction of T2DM with CAD was 0.803(95%CI 0.716～0.891,P<0.05),when the optimal cutoff value was 8.175ng/m L,the sensitivity was 80.0%and the specificity was70.1%.The area under the curve of serum OPG in the prediction of T2DM with CAD was 0.694(95%CI 0.586～0.803,P<0.05),when the optimal cutoff value was 0.412ng/m L,the sensitivity was 58.3%and the specificity was77.5%.3 Binary Logistic regression risk factor model showed that duration of diabetes(OR=1.205,95%CI 1.008～1.439,P<0.05),BMI(OR=1.389,95%CI1.013～1.905,P<0.05),OPG≥0.412ng/m L(OR=2.887,95%CI 1.850～8.515,P<0.05),OPN≥8.175ng/m L(OR=13.109,95%CI 2.557～67.204,P<0.05)were independent risk factors of T2DM with CAD.4 Spearman correlation analysis showed that serum OPN and OPG levels were positively correlated with Gensini score of T2DM(r=0.591,0.467,P<0.05).Conclusion:1 Serum OPN and OPG were biological markers that aid in the assessment of the condition and risk of T2DM with CAD;high levels of OPN and high levels of OPG were an independent risk factor for T2DM with CAD.2 The levels of serum OPN and OPG in T2DM patients were positively correlated with the severity of coronary artery disease,serum OPN and OPG level had predictive value for the severity of coronary artery disease in T2DM patients. |
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