| Objectives:To study the correlation between the levels of serum ILK and ALK1 and acute cerebral infarction in patients with type 2 diabetes mellitus,so that to provide new ideas for the prevention and treatment of acute cerebral infarction.Methods:A total of 180 patients with acute cerebral infarction were recruited including 118 males and 62 females,aged between 33 and 87 years old.All the patients were admitted in the Neurology Department of the affiliated Hospital of Chengde Medical College from March 2020 to February 2021.56 patients with type 2 diabetes mellitus(T2DM)complicated with acute cerebral infarction were recruted at the same time,including 33 males and 23 females.50 healthy people from the Health Examination Center of Chengde Central Hospital were selected as the normal control,including 21 males and29 females,aged from 22 to 63 years old,and 70 T2 DM patients without macrovascular diseases were selected as the T2 DM control group.The T2 DM patients were come from the Endocrinology Department of the affiliated Hospital of Chengde Medical College,including 38 males and 32 females,aged from 22 to 69 years old.Collect the general data of the participates,such as name,sex,age,time of onset,blood pressure,smoking,drinking history,diabetes history and duration,hypertension history,coronary heart disease history,cerebrovascular disease history and so on.Detection of blood routine and biochemical indexes:fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),alkaline phosphatase(ALP),homocysteine(Hcy),etc.Based on the value of neutrophil absolute value(NEUT),lymphocyte absolute value(LYMPH),monocyte absolute value(MONO),platelet(PLT),calculate Neutrophil-to-lymphoceto-monocyte ratio(NLR)、Monocyte-to-lymphocyte ratio(MLR)、piatelet-to-lymphocyte ratio(PLR).Cranial CT and carotid artery color Doppler ultrasonography were used to identified the diagnosis of acute cerebral infarction and arterial atherosclerosis for all the patients.The patients with acute cerebral infarction received the measurement of plain MRI or 1.5T DWI at the same time.The concentrations of serum ILK and ALK1 were determined by enzyme-linked immunosorbent assay(ELISA).Comparing the concentrations of serum ILK and ALK1 between the normal control and the patients with acute cerebral infarction,to investigate the association of ILK,ALK1 and acute cerebral infarction.According to the results of NHISS score,the patients with acute cerebral infarction were divided into three subgroups:normal group(N1=55),mild injury group(N2=68)and moderate-severe injury group(N3=57).The levels of ILK and ALK1 were compared among the three subgroups to explore the correlation between the levels of serum ILK and ALK1 and the degree of neurological impairment in patients with acute cerebral infarction.Patients with T2 DM were divided into acute cerebral infarction group and non-acute cerebral infarction group to explore the correlation between serum ILK,ALK1 levels and acute cerebral infarction in patients with T2 DM.Results:1.The correlation of serum ILK,ALK1 and acute cerebral infarction.1.1 Compared with the non-cerebral infarction group,the acute cerebral infarction group was older [62(55-68)vs 38(33-49),p < 0.001)] and has longer smoking history [95(52%)vs 4(8%),p=0.009];Compared with the non-cerebral infarction group,SBP [156.46 ±19.25 vs 118.00 ±11.44,p <0.001],DBP [92.83 ±12.42 vs 78.79 ±7.65,p < 0.001],TG [1.59(1.19-2.27)vs 0.94(0.69-1.28),p < 0.001],ALP [76.15(60.78-93.75)vs 52.00(46.00-61.00).P < 0.001],FBG [6.58(5.38-8.30)vs 5.20(4.90-5.40),p <0.001)increased significnatly,while HDL-C decreased significantly [1.10(0.86-1.29)vs 1.53(1.33-1.68),P < 0.001])in cerebral infarction group.There was no significant difference in TC,LDL-C,UA and drinking history.Compared with the non-cerebral infarction group,the concentration of ILK decreased significantly[19.33(10.05-28.27)vs 30.05(22.68-36.23),P<0.05],and the concentration of ALK1 increased significantly[110.00(100.00-180.00)vs 100.00(97.35-110.00),P<0.05] in the cerebral infarction group.1.2 According to the results of NHISS score,the patients with acute cerebral infarction were divided into three subgroup.Compared with the normal group,the age of mild injury group and moderate and severe injury group was significantly higher [59.84 ±9.54 vs 60.95 ±9.57 vs 64.11±9.26,P=0.024].The MLR [0.24(0.19-0.32)vs 0.28(0.23-0.34)vs0.30(0.22-0.41),P=0.032],FBG [6.17(5.18-7.99)vs 6.07(5.29-7.55)vs7.30(5.99-8.64),P=0.039],LDL-C [2.01(1.53-2.75)vs 2.09(1.52-2.83)vs2.62(1.93-3.39),P=0.048] in mild injury group and moderate and severe injury group was significantly higher.Compared with the normal control group,the onset time of mild injury group and moderate and severe injury group was significantly shortened [3.00(2.00-5.00)vs 2.00(1.00-4.00)vs1.83(1.00-3.00),P=0.001].The concentration of ILK in mild injury group and moderate and severe injury group decreased significantly [25.93(22.01-36.40)vs 16.36(10.18-25.00)vs 10.07(8.72-23.38),P<0.05].The concentration of ALK1 in mild injury group and moderate and severe injury group was significantly higher [97.00(90.00-110.00)vs 110.00(104.14-111.00)vs 180.15(180.05-180.60),P < 0.05)] compared with the normal group.1.3 Correlation analysis:There was a negative correlation between ILK and NHISS score(Rs=-0.430,P < 0.001),and a positive correlation between ALK1 and NHISS score(Rs=0.765,P < 0.001).ILK was negatively correlated with age(Rs=-0.231,P < 0.001),FBG(Rs=-0.224,P < 0.001)and ALP(Rs=-0.277,P < 0.001).While ALK1 was positively correlated with age(Rs=0.201,P=0.002),FBG(Rs=0.179,P=0.008),ALP(Rs=0.271,P < 0.001)and LDL-C(Rs=1.151,P=0.023).However,There was no significant correlation between ILK and LDL-C No significant correlation between ILK,ALK1 and TGH、TG、HDL-C、UA、NLR、MLR、PLR.1.4 Binary Logistic regression analysis : ILK(OR=0.921,95%CI0.876-0.968,P=0.001)was the protective factor of acute cerebral infarction,and ALK1(OR=1.047,95%CI 1.012-1.084,P=0.008)was the risk factor of acute cerebral infarction.2.The correlation of ILK,ALK1 and acute cerebral infarction in patients with T2DM2.1 compared with the non-cerebral infarction group,the concentration of ILK in the cerebral infarction group was decreased [19.33(9.48-28.80)vs45.64(26.43-55.59),P<0.05] and the ALK1 concentration was increased[110.00(94.30-180.00)vs 90.00(91.13-100.00),P<0.05] in the non-cerebral infarction group.2.2 In patients with type 2 diabetes mellitus,binary Logistic regression analysis: ILK(OR=0.935,95%CI 0.905-0.966,P < 0.001)was the protective factor of acute cerebral infarction,and ALK1(OR=1.064,95%CI1.019-1.110,P=0.005)was the risk factor of acute cerebral infarction.Conclusion:1.The level of ILK in acute cerebral infarction group decreased significantly,which was negatively correlated with NHISS score.ILK level was a protective factor for acute cerebral infarction.The level of ALK1 in acute cerebral infarction group was significantly higher than that in non-cerebral infarction group,which was positively correlated with NHISS score,and ALK1 level was a risk factor for acute cerebral infarction.2.In patients with type 2 diabetes,the level of serum ILK in patients with cerebral infarction was lower than that in patients without cerebral infarction,while the level of serum ALK1 in patients with cerebral infarction was higher than that in patients without cerebral infarction. |
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