2型糖尿病合并代谢综合征患者血清RAR、FAM19A5、LECT2的表达及与糖脂代谢的相关性

doi:10.11958/20250620

天津医药 ›› 2025, Vol. 53 ›› Issue (5): 523-527.doi: 10.11958/20250620

2型糖尿病合并代谢综合征患者血清RAR、FAM19A5、LECT2的表达及与糖脂代谢的相关性

鲍家军¹(), 顾婷², 顾云娟³

1 如皋市人民医院内分泌科（邮编226500）
2 超声科
3 南通大学附属医院内分泌科

收稿日期:2025-02-18 修回日期:2025-03-06 出版日期:2025-05-15 发布日期:2025-05-28
作者简介:鲍家军（1982），男，副主任医师，主要从事2型糖尿病及相关并发症方面研究。E-mail：baojiajun1982@163.com
基金资助:
南通市科技计划项目(MS22019005)

Correlation between serum RAR, FAM19A5 and LECT2 expression and glycolipid metabolism in patients with type 2 diabetes mellitus complicated with metabolic syndrome

BAO Jiajun¹(), GU Ting², GU Yunjuan³

1 Department of Endocrinology
2 Department of Ultrasound, Rugao People's Hospital, Rugao 226500, China
3 Department of Endocrinology, Affiliated Hospital of Nantong University

Received:2025-02-18 Revised:2025-03-06 Published:2025-05-15 Online:2025-05-28

鲍家军, 顾婷, 顾云娟. 2型糖尿病合并代谢综合征患者血清RAR、FAM19A5、LECT2的表达及与糖脂代谢的相关性[J]. 天津医药, 2025, 53(5): 523-527.

BAO Jiajun, GU Ting, GU Yunjuan. Correlation between serum RAR, FAM19A5 and LECT2 expression and glycolipid metabolism in patients with type 2 diabetes mellitus complicated with metabolic syndrome[J]. Tianjin Medical Journal, 2025, 53(5): 523-527.

摘要/Abstract

摘要：

目的探讨2型糖尿病（T2DM）合并代谢综合征（MS）患者血清红细胞分布宽度（RDW）与白蛋白（ALB）的比值（RAR）、序列相似家族19成员A5（FAM19A5）及白细胞衍生趋化因子2（LECT2）的表达及与糖脂代谢的相关性。方法选取119例T2DM患者为研究组，根据是否合并MS分为MS组（67例）和非MS组（52例）；同期在本院体检的健康者93例作为对照组。血细胞自动分析仪检测RDW，全自动生化分析仪检测ALB，并计算RAR；酶联免疫吸附试验检测血清FAM19A5、LECT2水平；Pearson法分析血清与糖脂代谢指标的相关性；受试者工作特征（ROC）曲线分析血清RAR、FAM19A5、LECT2对T2DM患者合并MS的诊断价值。结果与对照组相比，研究组总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FBG）以及血清RAR、FAM19A5、LECT2水平均升高，高密度脂蛋白胆固醇（HDL-C）降低（P<0.05）；与非MS组相比，MS组体质量指数（BMI）、T2DM病程、高血压史占比、血压、腰围及RAR水平，血清FAM19A5、LECT2、TG、空腹胰岛素（FINS）、FBG、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）均升高，HDL-C降低（P<0.05）；血清RAR、FAM19A5、LECT2与TG、FINS、FBG、HbA1c以及HOMA-IR呈正相关，与HDL-C呈负相关（P<0.05）。RAR、FAM19A5、LECT2三者单独及联合诊断T2DM患者合并MS的AUC为0.821、0.807、0.793和0.952，三者联合优于各自单独诊断的效能（P<0.05）。结论 T2DM合并MS患者血清RAR、FAM19A5、LECT2水平升高，其与糖脂代谢指标密切相关，三者联合对T2DM患者合并MS有较高的临床诊断价值。

关键词: 糖尿病，2型, 代谢综合征, 红细胞分布宽度与白蛋白比值, 序列相似家族19成员A5, 白细胞衍生趋化因子2

Abstract:

Objective To investigate the relationship between the serum red blood cell distribution width (RDW) to albumin (ALB) ratio, the expression of family with sequence similarity 19 member A5 (FAM19A5) and leukocyte cell-derived chemotaxin 2 (LECT2) with the glucose and lipid metabolism indexes in type 2 diabetes mellitus (T2DM) patients with metabolic syndrome (MS). Methods A total of 119 patients with T2DM were selected as the study group, and patients were divided into the MS group (67 cases) and the non-MS group (52 cases) based on whether they were complicated with MS. Meanwhile, 93 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group. RDW was detected by an automatic blood cell analyzer, and ALB was detected by an automatic biochemical analyzer. The ratio of RDW to ALB (RAR) was calculated. The serum levels of FAM19A5 and LECT2 were detected by enzyme-linked immunosorbent assay (ELISA). The correlation between serum and glycolipid metabolism indicators was analyzed by Pearson's method. The diagnostic value of serum RAR, FAM19A5 and LECT2 for MS in T2DM patients was analyzed by receiver operating characteristic (ROC) curve. Results Compared with the control group, the study group exhibited significantly higher levels of total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), serum RAR, FAM19A5 and LECT2, while high-density lipoprotein cholesterol (HDL-C) was significantly lower (P<0.05). Compared to the non-MS group, body mass index (BMI), duration of T2DM, history of hypertension, blood pressure, waist circumference, TG, fasting insulin (FINS), FBG, glycated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance (HOMA-IR), serum RAR, FAM19A5 and LECT2 were significantly increased, and HDL-C was decreased in the MS group (P<0.05). Serum RAR, FAM19A5 and LECT2 were positively correlated with TG, FINS, FBG, HbA1c and HOMA-IR, and which was negatively correlated with HDL-C (P<0.05). The area under the curve (AUC) for the diagnosis of T2DM patients with MS using RAR, FAM19A5 and LECT2 individually were 0.821, 0.807 and 0.793, respectively, and the combined AUC was 0.952, indicating that the combined diagnostic efficacy of RAR, FAM19A5 and LECT2 was superior to their individual efficacies (P<0.05). Conclusion Serum levels of RAR, FAM19A5 and LECT2 are elevated in T2DM patients with MS. These biomarkers exhibit a strong association with indices of glucose and lipid metabolism. The combination of these three markers has significant clinical diagnostic value for T2DM patients with MS.

Key words: diabetes mellitus, type 2, metabolic syndrome, red blood cell distribution width to albumin ratio, family with sequence similarity 19, member A5, leukocyte derived chemokine 2

中图分类号:

R587.1

图/表 5

参考文献 20

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组别		n	TC/ （mmol/L）		TG/ （mmol/L）		HDL-C/ （mmol/L）		LDL-C/ （mmol/L）
对照组		93	3.49±0.38		1.17±0.14		1.31±0.16		2.37±0.26
研究组		119	4.50±0.48		2.23±0.25		1.16±0.17		2.71±0.29
t			16.623^＊＊		36.634^＊＊		6.541^＊＊		8.860^＊＊
组别	FBG/ （mmol/L）			RAR		FAM19A5/（ng/L）		LECT2/ （μg/L）
对照组	4.95±0.52			0.26±0.05		102.43±19.21		15.41±3.96
研究组	9.36±0.97			0.37±0.08		152.79±28.64		29.87±6.54
t	39.608^＊＊			11.604^＊＊		14.583^＊＊		18.794^＊＊

组别		n	TC/ （mmol/L）		TG/ （mmol/L）		HDL-C/ （mmol/L）		LDL-C/ （mmol/L）
对照组		93	3.49±0.38		1.17±0.14		1.31±0.16		2.37±0.26
研究组		119	4.50±0.48		2.23±0.25		1.16±0.17		2.71±0.29
t			16.623^＊＊		36.634^＊＊		6.541^＊＊		8.860^＊＊
组别	FBG/ （mmol/L）			RAR		FAM19A5/（ng/L）		LECT2/ （μg/L）
对照组	4.95±0.52			0.26±0.05		102.43±19.21		15.41±3.96
研究组	9.36±0.97			0.37±0.08		152.79±28.64		29.87±6.54
t	39.608^＊＊			11.604^＊＊		14.583^＊＊		18.794^＊＊

组别		n	年龄/岁			性别（男/女）			BMI/（kg/m²）		T2DM病程/年				吸烟史		饮酒史			高血压史
非MS组		52	59.24±10.26			25/27			26.09±3.05		8.04±4.92				9（17.31）		6（11.54）			11（21.15）
MS组		67	57.13±9.85			29/38			27.63±3.49		9.76±4.25				12（17.91）		9（13.43）			26（38.81）
t或χ²			1.138			0.271			2.521^＊		2.044^＊				0.007		0.095			4.258^＊
组别	收缩压/mmHg				舒张压/mmHg		腰围/cm			RAR			FAM19A5/（ng/L）			LECT2/（μg/L）			TC/（mmol/L）
非MS组	123.21±13.27				78.20±7.48		87.11±8.69			0.31±0.07			126.54±24.26			24.76±5.19			4.47±0.58
MS组	129.42±11.85				83.76±8.13		96.27±9.16			0.42±0.11			173.16±32.71			33.84±7.42			4.53±0.42
T	2.691^＊＊				3.831^＊＊		5.533^＊＊			6.287^＊＊			8.601^＊＊			7.510^＊＊			0.654
组别	TG/（mmol/L）			HDL-C/（mmol/L）				LDL-C/（mmol/L）				FINS/（mU/L）		FBG/（mmol/L）				HbA1c/%			HOMA-IR
非MS组	1.21±0.27			1.30±0.33				2.75±0.29				5.84±1.08		8.72±1.15				7.23±1.08			2.14±0.58
MS组	3.03±0.89			1.05±0.27				2.68±0.36				9.64±1.79		9.85±1.07				8.96±2.14			3.94±0.83
T	14.235^＊＊			4.545^＊＊				1.143				13.511^＊＊		5.530^＊＊				5.324^＊＊			13.313^＊＊

组别		n	年龄/岁			性别（男/女）			BMI/（kg/m²）		T2DM病程/年				吸烟史		饮酒史			高血压史
非MS组		52	59.24±10.26			25/27			26.09±3.05		8.04±4.92				9（17.31）		6（11.54）			11（21.15）
MS组		67	57.13±9.85			29/38			27.63±3.49		9.76±4.25				12（17.91）		9（13.43）			26（38.81）
t或χ²			1.138			0.271			2.521^＊		2.044^＊				0.007		0.095			4.258^＊
组别	收缩压/mmHg				舒张压/mmHg		腰围/cm			RAR			FAM19A5/（ng/L）			LECT2/（μg/L）			TC/（mmol/L）
非MS组	123.21±13.27				78.20±7.48		87.11±8.69			0.31±0.07			126.54±24.26			24.76±5.19			4.47±0.58
MS组	129.42±11.85				83.76±8.13		96.27±9.16			0.42±0.11			173.16±32.71			33.84±7.42			4.53±0.42
T	2.691^＊＊				3.831^＊＊		5.533^＊＊			6.287^＊＊			8.601^＊＊			7.510^＊＊			0.654
组别	TG/（mmol/L）			HDL-C/（mmol/L）				LDL-C/（mmol/L）				FINS/（mU/L）		FBG/（mmol/L）				HbA1c/%			HOMA-IR
非MS组	1.21±0.27			1.30±0.33				2.75±0.29				5.84±1.08		8.72±1.15				7.23±1.08			2.14±0.58
MS组	3.03±0.89			1.05±0.27				2.68±0.36				9.64±1.79		9.85±1.07				8.96±2.14			3.94±0.83
T	14.235^＊＊			4.545^＊＊				1.143				13.511^＊＊		5.530^＊＊				5.324^＊＊			13.313^＊＊

指标	RAR	FAM19A5	LECT2
TC	0.127	0.089	0.171
TG	0.356^＊＊	0.427^＊＊	0.392^＊＊
HDL-C	-0.379^＊＊	-0.438^＊＊	-0.416^＊＊
LDL-C	-0.138	-0.106	-0.124
FINS	0.432^＊＊	0.492^＊＊	0.457^＊＊
FBG	0.446^＊＊	0.463^＊＊	0.469^＊＊
HbA1c	0.491^＊＊	0.458^＊＊	0.442^＊＊
HOMA-IR	0.427^＊＊	0.434^＊＊	0.468^＊＊

2型糖尿病合并代谢综合征患者血清RAR、FAM19A5、LECT2的表达及与糖脂代谢的相关性

Correlation between serum RAR, FAM19A5 and LECT2 expression and glycolipid metabolism in patients with type 2 diabetes mellitus complicated with metabolic syndrome

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变量	AUC（95%CI）	截断值	敏感度	特异度	约登指数
RAR	0.821（0.740~0.885）	0.34	0.702	0.885	0.586
FAM19A5	0.807（0.724~0.873）	134.75 ng/L	0.687	0.865	0.552
LECT2	0.793（0.709~0.861）	28.21 μg/L	0.657	0.923	0.580
三者联合	0.952（0.896~0.983）		0.925	0.846	0.772

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