VAP法和公式法测定残粒脂蛋白胆固醇对糖尿病患者颈动脉斑块的诊断价值

The diagnostic value of remnant lipoprotein cholesterol measured by VAP method and formula method for carotid artery plaques in diabetic patients

摘要:

目的]对垂直密度梯度离心全自动血脂谱检测(VAP)法与公式法测定残粒脂蛋白胆固醇(RLPC)进行分析,比较这两种方法在诊断糖尿病动脉粥样硬化中的临床价值。 [方法]自2022年6月至2024年6月,选取宁波鄞州中医院内分泌科的糖尿病患者作为研究对象,其中糖尿病合并颈动脉斑块患者107例,设为糖尿病斑块组；糖尿病无颈动脉斑块患者103例,设为糖尿病无斑块组。同时,选取同期来医院体检的健康人群102例,设为正常对照组。采用VAP法和公式法分别测定各组外周血RLPC水平(RLPCVAP和RLPC公式法),首先进行这两种方法学分析,然后绘制并计算RLPCVAP和RLPC公式法诊断糖尿病颈动脉斑块ROC曲线下面积(AUC)。 [结果]VAP法检测外周血RLPC的变异系数低于公式法,外周血RLPC采用公式法检测时负值率为3.21%,而采用VAP法检测的RLPC未出现负值。外周血RLPCVAP与RLPC公式法明显正相关(P＜0.01)。糖尿病无斑块组和糖尿病斑块组RLPCVAP水平明显小于RLPC公式法(P＜0.01)。外周血RLPCVAP诊断糖尿病颈动脉斑块的AUC值明显大于RLPC公式法。 [结论]VAP法测定外周血RLPC的方法学表现优于公式法。VAP法能精准检测RLPC水平,在诊断糖尿病动脉粥样硬化的临床效能方面,显著优于通过公式法计算的RLPC结果。

Abstract:

Aim To analyze the vertical auto profile (VAP) method and formula method to determine remnant lipoprotein cholesterol (RLPC), and compare the clinical value of the two methods in the diagnosis of diabetic atherosclerosis. Methods From June 2022 to June 2024, diabetes patients from the Endocrinology Department of Ningbo Yinzhou Hospital of Traditional Chinese Medicine were selected as the study subjects, including 107 patients with diabetes complicated with carotid plaque, who were set as the diabetic plaque group; there were 103 patients with diabetes without carotid plaque, and they were set as diabetic non-plaque group. Meanwhile, 102 healthy individuals who came to the hospital for physical examinations during the same period were selected as the normal control group. The RLPC level in peripheral blood of each group was measured by VAP method and formula method (RLPCVAP and RLPC_formula). First, methodogical comparisons of the two methods were performed, and then the area under the ROC curve (AUC) of RLPCVAP and RLPC_formula for diagnosing carotid plaque in diabetes was drawn and calculated. Results The coefficient of variation of peripheral blood RLPC detected by VAP method was lower than that of formula method. The negative rate of peripheral blood RLPC detected by formula method was 3.21%, while RLPC detected by VAP method did not show negative values.There was a significant positive correlation between peripheral blood RLPCVAP and RLPC_formula (P＜0.01). The levels of RLPCVAP in diabetic plaque group and diabetic non-plaque group was significantly lower than those of RLPC_formula (P＜0.01). The AUC value of peripheral blood RLPCVAP in the diagnosis of carotid plaque in diabetes was significantly greater than that of RLPC_formula. Conclusion The methodological performance of VAP method for measuring peripheral blood RLPC is superior to formula method. VAP method can accurately detect the level of RLPC, which is significantly superior to the RLPC results calculated by formula method in the clinical efficacy of diagnosing diabetic atherosclerosis.