| Objectives:This study aims to investigate the correlation of serum A disintegrin and metalloproteinase 10(ADAM 10)level in type 2 diabetes mellitus(T2DM)and its related arteriosclerotic cardiovascular disease(ASCVD),and to explore the basic mechanisms and influencing factors.Methods:A total of 400 cases of T2DM,coronary atherosclerotic heart disease(CHD)and healthy subjects admitted to the First Affiliated Hospital of Kunming Medical University from September 2017 to December 2018 were involved in this study.The participants were divided into T2DM group(n=100),CHD group(n=100),T2DM with CHD group(n=100),and control group(n=100).We’ve collected clinical items,including gender,age,disease course,blood pressure,height,weight,and calculated body mass index.Fasting elbow venous blood was extracted for the determination of triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,fasting blood glucose,2-hour postprandial blood glucose,HbAlc and fasting insulin,and then the insulin resistance index was calculated.The levels of serum ADAM 10 were tested by enzyme-linked immunosorbent assay(ELISA).87 subjects in the T2DM group accepted carotid artery ultrasound examination.According to the degree of atherosclerosis,they were divided into non-atherosclerotic group(n=25),thickened IMT group(n=14),and atherosclerosis group(n=48).Then,according to whether the T2DM patients complicated with carotid atherosclerosis(CAS),they were divided into simple T2DM group(n=25)and T2DM with CAS group(n=62).The difference of serum ADAM 10 levels among the groups was compared by analysis of variance.Spearman test was used to analyze the correlation factors of ADAM 10.Risk factors for aggravation of carotid atherosclerosis in patients with T2DM were analyzed by ordered multi-classification Logistic regression.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of serum ADAM 10 level in T2DM with ASCVD.Results:①The serum ADAM10 concentration in T2DM group(1833.44±778.69 pg/ml),CHD group(2015.95±802.10 pg/ml)and T2DM-CHD group(1983.09±734.88 pg/ml)was significantly higher than that in control group(1485.77±530.12 pg/ml),and the difference was statistically significant(P<0.05).After excluding the influence of confounding factors by covariance analysis,serum ADAM10 in CHD group and T2DM-CHD group were still higher than that in control group with statistical significance difference(P<0.05).②The serum ADAM 10 in T2DM with CAS(1975.73±787.30 pg/ml)was higher than that in control group(1485.77±530.12 pg/ml)(P<0.05).The difference was still significant after adjusting the influencing factors by analysis of covariance.③In patients with T2DM,the level of serum ADAM10 increased with the aggravation of atherosclerosis(1676.12±736.42 pg/ml→1835.00±798.79 pg/ml→2016.77±787.63 pg/ml),but there was no significant difference(P>0.05).④Logistic regression analysis showed that the duration of diabetes,age,systolic blood pressure and serum ADAM 10 were the risk factors for the aggravation of AS in T2DM patients.⑤Spearman correlation test showed that serum ADAM 10 level was positively correlated with systolic blood pressure(r=0.154,P<0.05),triglyceride(r=0.181,P<0.05),BMI(r=0.181,P<0.05)and was negatively correlated with HDL-C(r=-0.276,P<0.05).⑥ROC curve analysis showed that the area under ROC curve(AUC)of serum ADAM 10 for predicting CHD was 0.683,95%CI was(0.609,0.757),the best cutoff value was 2158.0pg/ml,the sensitivity was 0.45,the specificity was 0.92.The AUC of serum ADAM 10 for predicting T2DM complicated with CHD was 0.698,95%CI was(0.626,0.770),the best cutoff value was 2028.0pg/ml,the sensitivity was 0.44,the specificity was 0.87.The AUC of serum ADAM 10 for predicting T2DM complicated with carotid aerosclerosis(CAS)was 0.696,95%CI was(0.611,0.785),the best cutoff value was 1977pg/ml,the sensitivity was 0.50,the specificity was 0.85.Conclusions:①The level of serum ADAM 10 in T2DM with CHD and T2DM with CAS was higher than that in control group,but there was no significant difference in serum ADMA 10 between T2DM group and control group.Furthermore,in T2DM patients,with the aggravation of carotid atherosclerosis,serum ADAM 10 tends to increase,suggesting that ADAM 10 may promote the occurrence and progression of atherosclerosis in T2DM patients.②Increased of serum ADAM 10,prolonged duration of diabetes,aging and elevated systolic blood pressure are the risk factors for the aggravation of cervical atherosclerosis in T2DM patients.③Serum ADAM 10 level was positively correlated with systolic blood pressure,triglyceride,body mass index,and negatively correlated with HDL-C.④ROC curve analysis indicated that serum ADAM 10 level might have some predictive value for CHD and T2DM with ASCVD. |
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