血清SIRT1和ChREBP在肝硬化合并肝源性糖尿病的早期识别及风险分层应用价值研究OA

Objective:To investigate the expression of Sirtuin 1(SIRT1)and carbohydrate-responsive element binding protein(ChREBP)in patients with liver cirrhosis complicated by hepatogenous diabetes(HD)and their potential value in early identification and risk stratification.Methods:A total of 86 patients with liver cirrhosis and HD and 103 patients with liver cirrhosis alone were enrolled as the cirrhosis-HD group and the cirrhosis group,respectively.Clinical data,SIRT1,and ChREBP levels were compared between groups.Logistic regression and ROC curve analyses were performed to identify risk factors and predictive values for HD in cirrhotic patients,while Spearman correlation analysis explored relationships between variables.Results:SIRT1 levels decreased,and ChREBP levels increased with worsening Child-Pugh grades,accompanied by significant risk stratification changes(all P＜0.05).Serum FBG,ALT,Urea,Alb,TBil,2hPG,fasting plasma insulin,HOMA-IR,HbA1c,SIRT1,and ChREBP levels showed progressive trends across low,medium,and high-risk stratifications(P＜0.05).Age,cirrhosis duration,Child-Pugh grade,FBG,TBil,Alb,2hPG,fasting plasma insulin,HOMA-IR,HbA1c,SIRT1,and ChREBP were independent predictors of HD in cirrhotic patients.SIRT1 levels positively correlated with Alb and fasting plasma insulin but negatively correlated with ChREBP,FBG,2hPG,HOMA-IR,and HbA1c;the opposite was true for ChREBP.The AUC values for Sirtuin 1 and ChREBP in predicting HD were 0.925 and 0.841,respectively,with cutoffs of 1.02 and 1.31 yielding sensitivities of 0.913 and 0.826 and specificities of 0.897 and 0.871.Conclusion:Decreased SIRT1 and increased ChREBP levels in cirrhotic patients with HD show promising clinical utility for early diagnosis and risk stratification of HD.