检验医学与临床2026，Vol.23Issue(3)：397-403,7.DOI:10.3969/j.issn.1672-9455.2026.03.018
血清GLP-1、DKK1、ACSL4水平与2型糖尿病合并急性ST段抬高型心肌梗死患者PCI术后预后不良的关系
The relationship between serum levels of GLP-1,DKK1 and ACSL4 and poor prognosis after PCI in patients with type 2 diabetes and acute ST-segment elevation myocardial infarction
摘要
Abstract
Objective To investigate the relationship between serum levels of glucagon-like peptide-1(GLP-1),Dickkopf-related protein 1(DKK1),and acyl-coA synthetase long-chain family member 4(ACSL4)and the poor prognosis of patients with type 2 diabetes mellitus(T2DM)and acute ST-segment elevation my-ocardial infarction(ASTEMI)after percutaneous coronary intervention(PCI).Methods A total of 119 pa-tients with T2DM and ASTEMI admitted to the hospital from August 2022 to August 2024 were selected as the ASTEMI group.They were divided into mild coronary artery lesion group(56 cases),moderate coronary artery lesion group(41 cases),and severe coronary artery lesion group(22 cases)according to the Gensini score.Another 119 patients with simple T2DM admitted to the hospital during the same period were selected as the T2DM group,and 119 healthy individuals undergoing physical examination at the same period were se-lected as the control group.The ASTEMI group was divided into poor prognosis group and good prognosis group based on whether major adverse cardiovascular events occurred within half a year after PCI.Serum lev-els of GLP-1,DKK1 and ACSL4 were detected by enzyme-linked immunosorbent assay.Multivariable Logistic regression analysis was used to analyze the influencing factors of poor prognosis in T2DM complicated with ASTEMI after PCI.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum GLP-1,DKK1 and ACSL4 alone and in combination for poor prognosis of T2DM complicated with ASTEMI after PCI.Results The serum levels of GLP-1,DKK1 and ACSL4 in the ASTEMI group were high-er than those in the control group and the T2DM group,and those in the T2DM group was higher than those in the control group,and the differences were statistically significant(P<0.05).The serum levels of GLP-1,DKK1 and ACSL4 in the severe coronary artery lesion group were higher than those in the mild coronary ar-tery lesion group and the moderate coronary artery lesion group,and those in the moderate coronary artery le-sion group were higher thanthose in the mild coronary artery lesion group,and the differences were statistical-ly significant(P<0.05).The glycosylated hemoglobin(HbA1c)and serum levels of GLP-1,DKK1 and AC-SL4 in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).The results of Multivariable Logistic regression analysis showed that ele-vated HbA1c and serum levels of GLP-1,DKK1 and ACSL4 were risk factors for poor prognosis in patients with T2DM and ASTEMI after PCI(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of the combined prediction of the GLP-1,DKK1 and ACSL4 for poor prognosis of patients with T2DM and ASTEMI after PCI was 0.947,which was larger than the AUC of GLP-1,DKK1 and ACSL4 alone(Z=4.316,3.788,3.487,all P<0.05).Conclusion The serum levels of GLP-1,DKK1 and ACSL4 in patients with T2DM and ASTEMI are elevated,which can reflect the severity of coronary artery lesions and can be used as biomarkers for predicting poor prognosis of patients with T2DM and ASTEMI after PCI.More-over,the combined detection of the three indicators has a higher predictive efficacy.关键词
2型糖尿病/急性ST段抬高型心肌梗死/胰高血糖素样肽-1/Dickkopf相关蛋白1/酰基辅酶A合成酶长链家族成员4/冠状动脉病变/经皮冠状动脉介入治疗Key words
type 2 diabetes mellitus/acute ST-segment elevation myocardial infarction/glucagon-like peptide-1/Dickkopf-related protein 1/acyl-coA synthetase long-chain family member 4/coronary artery lesion/percutaneous coronary intervention分类
医药卫生引用本文复制引用
翟双久美,程光慧,李迎婕,王慧,李新军..血清GLP-1、DKK1、ACSL4水平与2型糖尿病合并急性ST段抬高型心肌梗死患者PCI术后预后不良的关系[J].检验医学与临床,2026,23(3):397-403,7.基金项目
河北省张家口市重点研发计划项目(2221082D). （2221082D）
