| Objective:In this study,we examined the types of carotid atherosclerotic plaque,serum adipocyte fatty acid binding protein(A-FABP)and homocysteine(Hcy)concentration in patients with Type 2 diabetes mellitus(T2DM),to provide an important indicator for the prediction of type 2 diabetes mellitus combined with cerebral infarction(DMCI)through exploringthe role and expression of three indicators in the occurrence and development of T2 DM.Methods:The T2 DM patients who were hospitalized in Chengde Central Hospital from January 2016 to July 2016 were selected as the research object,the number was 89 cases.Then these subjects were divided into two groups according to with cerebral infarction,one of the two groupsis type 2 diabetic group(T2DM group),the number is 45 cases;another group is type 2 diabetes complicated with cerebral infarction group(or group DMCI),the number is 44 cases.In addition,30 healthy subjects who at the same time in our hospital for physical examinationwere selected as normal control(Normal control),and were set as normal control group(group NC).All the subjects in the control group were excluded from heart,liver,kidney and other organs,and there was no history of diabetes and hypertension.The basic data of the three groups were recorded,such as age,blood pressure,height,weight and body mass index,and blood glucose(FPG),glycosylated hemoglobin(HbA1c),blood lipids(TG,TC,LDL-C,HDL-C),homocysteine(Hcy),adipocyte fatty acid binding protein(A-FABP)and carotid plaque type were detected,statistical analysis of NC group,T2 DM group and DMCI group,the expression of these indicators and whether the correlation.All the patients with T2 DM were divided into two groups according to the type of carotid artery plaque,there were without plaque group(n=15),stable plaque group(n=60)and unstable plaque group(n=14).The levels of A-FABP and Hcy were analyzed and compared between the three groups.Statistical software SPSS 19 was used to analyze all the data,the measurement data was descriptionedwith mean±SD,the comparison between the three groups was based on the analysis of variance(ANOVA).Count data were compared by chi square test;correlation analysis using Pearson correlation analysis.P < 0.05 indicates that the difference is statistically significant.Results:1 Age,Smoking situation,BMI,blood glucose,blood pressure,blood lipids and other indicators in the NC group,T2 DM group and DMCI group were comparedThrough the study of the three groups of age,Smoking situation,FPG,HbA1 c,SBP,DBP,TG,TC,LDL-C,HDL-C and other indicators were compared,the results showed that age,HbA1 c,SBP,DBP,LDL-C increased gradually in the three groups,the level of HDL-C in the three groups was gradually reduced,the difference was statistically significant(P< 0.05);The levels of FPG and TG were not different between the DMCI group and the T2 DM group(P> 0.05),but compared with the NC group,the levels in the DMCI group and the T2 DM group were significantly higher,the difference was statistically significant(P< 0.05).There was no difference of the BMI and Smoking situation between the three groups(P> 0.05).2 Comparison of serum Hcy and A-FABP concentrations in three groupsThe concentration of Hcy in the NC group was6.47±2.05 umol/l,in the T2 DM group was8.18±2.82 umol/l,in the DMCI group was 12.55±3.27 umol/l.The concentration of A-FABP in the NC group was 18.74±4.33 ng/ml,in the T2 DM group was 32.83±5.73ng/ml,in the DMCI group was 37.95±5.73 ng/ml.The concentrations of Hcy and A-FABP were compared between the three groups,the difference was statistically significant(P< 0.05),and the levels of both were the highest in the DMCI group.3 The detection rate of carotid plaque in NC group,T2 DM group and DMCI groupIn the NC group,the number of plaques was 6(20%),the number of plaques in the T2 DM group was 32(71.1%),and the number of plaques in the DMCI group was 42(95.5%),The carotid plaque in three groups were contrasted(χ2=46.59,P=0.000)in the three groups,suggesting that the plaque detection rate is different,there is a statistically significant(P< 0.05).Multiple comparisons were made between the three groups,the results showed: between NC group and T2 DM group(χ2=18.81,P=0.000);between NC group and DMCI group(χ2=44.56,P=0.000);between simple T2 DM group and DMCI group(χ2=9.408,P=0.002),the differences were statistically significant(P< 0.05).4 Comparison of plaque composition in T2 DM group and DMCI groupIn the T2 DM group,the number of patients without plaque was 13(28.9%),the number of stable plaques was 29(64.4%)and the number of unstable plaques was 3(6.7%).In group DMCI,the number of patients without plaque was 2(4.5%),the number of stable plaques was 31(70.5%)and the number of unstable plaques was 11(25%).By comparing the composition ratio of the two groups(χ2=12.7,P=0.002),the difference was statistically significant(P< 0.05).In the two groups,the detection rate of unstable plaque was different(χ2=5.64,P=0.018),the difference was statistically significant(P< 0.05).5 The levels of A-FABP and Hcy in all the patients with T2 DM were compared with those of different types of plaquesThe concentration of A-FABP in the non plaque group was30.33±5.93 ng/ml,stable plaque group was 34.97±4.98 ng/ml,unstable plaque group was 42.40±5.56 ng/ml;The levels of Hcy in the three groups were 7.87±2.85 umol/l、10.15±3.54 umol/l、13.79±3.02 umol/l.After comparison,the concentrations of A-FABP and Hcy in three groups were gradually increased,and there was statistical difference(P< 0.05).6 Correlation analysis of serum A-FABP levels with FPG,serum lipids and Hcy levels in all subjectsSerum A-FABP was positively correlated with FPG(r=0.528),TG(r=0.225),TC(r=0.422),LDL-C(r=0.422)and Hcy(r=0.377),and negatively correlated with HDL-C(r=-0.627)level,P< 0.05.Conclusion:1 With the progress of the disease,the incidence of carotid plaques in patients with T2 DM is higher and higher,and the formation of unstable plaque was significantly correlated with the occurrence of cerebral infarction.2 Serum A-FABP levels correlated with Hcy levels,The increase of both levels may be related to the formation of carotid atherosclerotic plaque and plaque instability.3such as age,HbA1 c,TC,LDL-C,the level of serum A-FABP and Hcyis related to the occurrence of cerebral infarction in patients of T2 DM.4 The serum A-FABP and Hcy levels in patients with T2 DM may be the same as the type of carotid plaques,which can be used as predictors of T2 DM macrovascular complications.By combining these three indicators together,we can analyze the situation of carotid artery disease in type 2 diabetes mellitus more comprehensively,and then prevent the occurrence of cerebral infarction in the early stage. |
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