Effects of serum amyloid A on adverse cardiovascular events in patients with type 2 diabetes
ZHU Xinjian1, DONG Yuehua1, LI Pengyu2, XI Xiaoping2
1. Department of Internal Medicine; 2. Department of Special Diagnosis,Beijing Municipal Corps Hospital, Chinese People's Armed Police Force, Beijing 100027, China
Abstract：Objective To investigate the effects of serum amyloid A (SAA) on adverse cardiovascular events in patients with type 2 diabetes. Methods A total of 98 patients with type 2 diabetes diagnosed in Beijing Armed Police Corps Hospital between March to December of 2016 were selected as the subjects. These patients were followed up for two years and divided into the occurrence group (n=38) and the non-occurrence group (n=60). The clinical characteristics of the two groups were compared. Correlations between SAA and adverse cardiovascular events were analyzed, and the ROC curve was used to analyze the predictive value of SAA for adverse cardiovascular events. Results Of the 98 cases, 38 experienced adverse cardiovascular events (occurrence group), accounting for 38.8% and including 18 cases of acute coronary syndrome (47.4%), 12 cases of heart failure (31.6%), 6 cases of symptomatic arrhythmias (15.8%), 1 case of cardiac arrest (2.6%), and 1 case of death (2.6%). By contrast, 60 cases reported no adverse cardiovascular events (non-occurrence group), accounting for 61.2%. The proportion of patients with adverse cardiovascular events who were sixty or above and complicated with hypertension was significantly higher in the occurrence group than in the non-occurrence group, and the difference was statistically significant (P<0.05). The level of LVEF in patients with adverse cardiovascular events was significantly lower in the occurrence group than in the non-occurring group, and the difference was also statistically significant (P<0.05). Multivariate Logistic regression model analysis suggested that age ≥60 years and elevated levels of low-density lipoprotein, CRP, homocysteine and SAA were independent risk factors for adverse cardiovascular events in patients with type 2 diabetes (P<0.05). The AUC of CRP was 0.6186, and the diagnostic cutoff was 4.81,compared with 0.7248 and 10.96 for SAA. Conclusions Patients with type 2 diabetes are at higher risk of adverse cardiovascular events within 2 years. Patients aged 60 or above, with high LDL-C levels of low-density lipoprotein, CRP, homocysteine and SAA are more susceptible to adverse cardiovascular events. Elevated SAA levels are of predictive value for the risk of adverse cardiovascular events in patients with type 2 diabetes.
朱新建, 董月华, 李鹏宇, 席晓萍. 血清淀粉样蛋白A对2型糖尿病患者不良心血管事件的影响[J]. 武警医学, 2020, 31(6): 516-519.
ZHU Xinjian, DONG Yuehua, LI Pengyu, XI Xiaoping. Effects of serum amyloid A on adverse cardiovascular events in patients with type 2 diabetes. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(6): 516-519.
Raggi P,Genest J, Giles J T,et al.Role of inflammation in the pathogenesis of atherosclerosis and therapeutic interventions[J].Atherosclerosis,2018,276:98-108.
[3]
朱国富,李希杰,阮志敏,等. 血清淀粉样蛋白 A 与老年冠心病患者冠状动脉病变严重程度的相关性分析[J]. 中华老年心脑血管病杂志, 2016,18(11):1161-1164.
[4]
Kim M H,Beer M C,Wroblewski J M,et al.Impactofindividual acute phase serunl amyloid A isoforms on HDL metabolism in mice[J].J Lipid Res,2016,57(6):969-979.
2020, Vol. 31 
