Effects Of Multifactorial Intervention On SAA And IMT Of Conducting Artery In Newly-Diagnosed Type 2 Diabetes

Background: Macrovascular complications (atherosclerosis, AS) are the most common causes of mortality in patientes with type 2 diabetes mellitus (T2DM). Increasing evidence indicates that chronic subclinical inflammation may play an important role in the pathogenesis of T2DM and its macroangiopathy. Serum amyloid A (SAA), an acute-phase reactant protein, has been shown to be as a predictor of cardiovascular disease risk and events. But the association between SAA and T2DM and its macroangiopathy remains uncertain. Moreover, the change of the level of SAA and intima-media thickness (IMT) of conducting artery after multifactorial intervention in type 2 diabetes is seldom reported.Objective: To investigate the effects of multifactorial intervention on SAA and IMT of conducting artery and their relationship in newly-diagno- sed type 2 diabetes.Methods: Fifty-eight newly-diagnosed type 2 diabetes were treated with intensive integrated therapy targeting hyperglycemia, dyslipidemia, hypertension and subclinical inflammation for 4 years and sixty healthy subjects were taken as the control group. Type 2 diabetes enrolled were required to be as follows: a duration of no more than one year, no ketosis, no evidence of heart, brain, kidney disease or peripheral atherosclerosis, IMT is less than 1.0mm examed by ultrasonography. The serum concentr- ations of fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein chole- sterol (LDL-C), high density lipoprotein cholesterol (HDL-C), high sensitive C-response protein (hs-CRP) and SAA level were assayed in allsubjects. IMT of conducting artery was measured by ultrasonography in type 2 diabetes at baseline and 4 years treatment.Results: Compared with the control group, SAA level (lnSAA) of Type 2 diabetes increased significantly (6.43±1.19 vs 6.02±0.65, p<0.05). At the end of 4 years therapy, type 2 diabetes had lower SAA level (6.43±1.19 vs 6.20±0.88, p<0.05) and no significantly difference in IMT (0.74mm±0.08 vs 0.78mm±0.14, p>0.05). Moreover, SAA level was positively correlated with waist hip ratio (WHR), TC and hs-CRP (P=0.006, 0.062, 0.000) while was negatively correlated with HDL-C (P=0.065).Conclusions: SAA level increased in type 2 diabetes, which was associated with T2DM and the related risk factors of diabetic macrovascular disease, SAA may be one of the risk factors in type 2 diabetes with atherosclerosis. For newly-diagnosed type 2 diabetes, effective interventi- ons including treatment of hyperglycemia, dyslipidemia and aspirin therapy significantly reduce SAA level and may prevent the progression of macrovascular complications.