| Objective:As the incidence of type 2 diabetes increases,the prevalence of type 2diabetes in China exceeds 10%.Type 2 diabetes and its complications reduce people’s quality of life,and also increase the economic burden of our country.Macrovascular complications are the leading cause of death in type 2 diabetes.Diabetes causes complications in all major artery,including coronary,intracranial,and peripheral arteries.Peripheral arterial plaque is closely related to macrovascular complications.Due to the convenience and cheapness of peripheral atherosclerosis examination,the first part of our study establishs a risk model for predicting the occurrence of peripheral arterial plaque in type 2 diabetes.Studying the role of different inflammatory mediators in peripheral arterial plaques may help clarify the exact pathogenesis of macrovascular complications in type 2diabetes.Neopterin is an inflammatory factor,and C1 q tumor necrosis factor related protein-1(C1Q/TNF-1)is an adipokine.There are many studies on the correlation between serum neopterin and C1Q/TNF-1 levels and peripheral atherosclerosis.The second part of this study aims to clarify the relationship between arterial plaque and serum neopterin and C1Q/TNF-1 in type 2 diabetes.Methods:In the first part of the study we collected 832 patients with type 2 diabetes who were admitted to the endocrinology department of Changhai Hospital from May 2018 to March 2019.After collecting relevant indicators,they were divided to two groups according to whether there were carotid plaques or lower extremity arterial plaques.75%of all data were randomly selected as the modeling group and the other 25% were used as the verification group.independent sample t test or χ2 analysis was used for comparison between groups by SPSS 22.0.The data were analyzed by using single-factor and multi-factor logistic regression models to determine independent influencing factors.Independent influence factors were introduced into R software to build a predictive nomogram,and the model was verified internally and externally.In the second part we randomly selected 121 patients with type 2 diabetes from December 2016 to February2018.After collecting relevant indicators,we collected serum from all patients,and measured neopterin and C1Q/TNF-1 levels through enzyme linked immune sorbent assay.They were divided into two groups according to the presence or absence of carotid plaques and lower extremity arterial plaques.Independent sample t test was used to compare the groups by SPSS 22.0.Multivariate Logistic regression was used to determine theindependent influencing factors.The correlation between the two variables was analyzed by Spearman rank correlation.P < 0.05 was considered to be statistically significant.Results : 1.the occurrence of carotid plaque in patients with type 2 diabetes was independently related to age,history of lipid-lowering drugs,systolic blood pressure,hip circumference,lymphocytes,total bilirubin,serum urea,serum creatinine,indirect bilirubin,estimated glomerular filtration rate(e GFR),two hours Blood glucose,diabetic retinopathy,carotid artery intima-media thickness and femoral artery intima-media thickness.Then a nomogram of carotid plaque in patients with type 2 diabetes was established.2.the independent influencing factors of lower extremity arterial plaque in patients with type 2diabetes were gender,age,history of antihypertensive drugs,lipid-lowering drugs,antiplatelet drugs,smoking history,smoking index,systolic blood pressure,BMI,white blood cells,neutrophils count,alanine transaminase,fatty liver,diabetic retinopathy and femoral artery intima-media thickness.And a nomogram of femoral plaque in patients with type 2 diabetes was established.3.Serum neopterin levels in the type 2 diabetes patients with carotid plaque were significantly higher than the group without carotid plaque,and there was no statistical difference in the level of C1Q/TNF-1 between the carotid plaque group and the carotid plaque-free group.Neopterin was an independent risk factor for carotid plaque in patients with type 2 diabetes.There was also no statistical difference in the levels of neopterin and C1Q/TNF-1 between the group with lower extremity arterial plaque and the group without lower extremity arterial plaque.4.Serum neopterin levels in patients with type 2 diabetes were positively correlated with BMI and serum creatinine,and negatively correlated with e GFR.Conclusion:Establish a nomogram of peripheral arterial plaque in patients with type2 diabetes.It is confirmed that neopterin is an independent risk factor for carotid plaque in patients with type 2 diabetes,and serum neopterin levels are associated with BMI,creatinine,and e GFR in patients with type 2 diabetes. |
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