Clinical significance of serum soluble semaphorin 4D for predicting diabetic microangiopathy in type 2 diabetic patients / 中国医师进修杂志

ABSTRACT

Objective:To detect the levels of serum soluble semaphorin 4D in patients with type 2 diabetes, and to investigate the predictable value for diabetic microangiopathy (DMAP).Methods:A total of 210 type 2 diabetes patients were divided into non-DMAP group (96 cases), single-DMAP group (77 cases) and composite DMAP group (combination of two or three DMAP, 37 cases) according to the DMAP status. The general clinical data and laboratory indicators were collected, meanwhile, the levels of serum soluble semaphorin 4D were measured by enzyme-linked immunosorbent assay. The risk factors related to DMAP were analyzed by multiple ordered Logistic regression model, and the predictable value of serum soluble semaphorin 4D for DMAP was evaluated by receiver operating characteristic (ROC) curve.Results:The difference of course of diabetes [(5.02 ±1.00), (6.26 ± 2.13), (8.42 ± 2.82) years], systolic blood pressure (SBP)[(131.81 ± 18.06), (141.81 ± 22.51), (142.88 ± 17.06) mmHg, 1 mmHg=0.133 kPa], hypertension ratio [37.5%(36/96), 50.6%(39/77), 35.1%(22/37)], postprandial blood glucose (PPG)[(13.56 ± 2.02), (14.94 ± 2.50), (15.88 ± 2.45) mmol/L], hemoglobin (HbA 1c) [(8.17 ± 2.17)%, (9.14 ± 1.51)%, (9.69 ±1.58)%], soluble semaphorin 4D [(1.18 ± 0.27), (1.89 ± 0.53), (2.21 ± 0.79) μg/L] among non-DMAP group, single-DMAP group, composite DMAP group had statistical significance ( P<0.05). The levels of diabetes course, SBP, hypertension ratio, PPG, HbA 1c and serum soluble semaphorin 4D were significantly increased in the single-DMAP group and composite DMAP group compared to those in the non-DMAP group, the levels of diabetes course, PPG and serum soluble semaphorin 4D were significantly increased in the composite DMAP group compared to those in the non-DMAP group, and the differences were statistically significant ( P<0.05). Logistic regression analysis showed that serum soluble semaphorin 4D, diabetes course, hypertension ratio, PPG was independent risk factor for the DMAP ( P<0.05). ROC curve demonstrated that serum soluble semaphorin 4D>1.52 μg/L (AUC=0.873) may indicate the occurrence of single DMAP, whereas serum soluble semaphorin 4D>1.91μg/L (AUC=0.740) may predictethe occurrence of composite DMAP. Conclusions:Serum soluble semaphorin 4D is an independent risk factors for DMAP and may be considered as an potential serum maker to screen DMAP.