| Objective:The incidence of Type 2 diabetes mellitus(T2DM)complicated with atherosclerosis is high,which is the main cause of death in most patients with T2DM,and seriously affects the quality of life and life span of patients with T2DM.The occurrence of Carotid atherosclerosis(CAS)was earlier than that of other arteries,with its shallow location,which was advantageous for examination,and could be used as an observational index of vascular atherosclerosis.Bile acid(BA)is a derivative of cholesterol metabolism in vivo,which not only participates in the dissolution of lipids and promotes the absorption of lipid-soluble vitamins,but also regulates the metabolism of carbohydrates,lipids and energy in the body.Therefore,this study analyzed the characteristics,risk factors,Serum total bile acid(S-TBA)and correlation of various indicators in T2DM patients with CAS,in order to provide new ideas for the diagnosis and treatment of T2DM patients with CAS.Methods:A total of 836 T2DM patients admitted to endocrinology Department of Jinan Central Hospital from October 2020 to October 2021 were retrospectively analyzed.According to the results of cervical vascular ultrasonography,the patients were divided into T2DM group(230 cases)and T2DM combined with CAS group(606 cases).Based on Glycosylated Hemoglobin(hemoglobin,HbA1c),it is divided into G1 group(HbA1c<7%)and G2 group(HbA1c≥7%).T2DM patients with CAS were divided into four groups by S-TBA quartile method:Q1 group(<2.8μmmol/L),Q2 group(≥2.8μmmol/L,<4.2μmmol/L),Q3 group(≥4.2μmmol/L,<5.98μmmol/L)and Q4 group(≥5.98μmmol/L).SPSS 27.0 was used for statistical analysis.K-S test was used to judge the normality of all data.Independent sample T test was used to compare the data consistent with normal distribution between the two groups.The Mann-Whitney U test was used to compare the non-normal distribution data between two groups,and the Kruskal-Wallis H test was used to compare the data between multiple groups.Categorical variable data were compared by chi-square test.Spearman correlation analysis of S-TBA and clinical parameters.Binary Logistic regression was used to analyze the risk factors of T2DM with CAS.Results:(1)Age,duration of diabetes mellitus,prevalence of hypertension,coronary heart disease,cerebrovascular disease,Systolic blood pressure(SBP),Waist Circumference(Waist Circumference,waist circumference,waist circumference,waist circumference,waist circumference,waist circumference,waist circumference,WC),Blood urea nitrogen(BUN),Creatinine(Cr),Brachial ankle pulse wave velocity(baPWV)levels were higher than those of T2DM group.Fasting plasma glucose(FPG),Glucose triglyceride index(TyG),Triglyceride(Triglyceride,The levels of TG,Alanine transaminase(ALT)and Aspartate aminotransferase(AST)were lower than those of T2DM group,and the difference was statistically significant(P<0.05).(2)The levels of age,diabetes course,hypertension,coronary heart disease,cerebrovascular disease,SBP,TG,High density lipoprotein cholesterol(HDL-C)and baPWV in male T2DM patients with CAS group were higher than those in T2DM group.The levels of TyG,ALT,AST and Uric acid(UA)were lower than those of T2DM group,and the differences were statistically significant(P<0.05).Age,diabetes course,hypertension,coronary heart disease rate,SBP,Body Mass Index(BMI),WC,Visceral fat area,visceral fat area,visceral fat area,visceral fat area,visceral fat area,visceral fat area,visceral fat area,visceral fat area VFA),Subcutaneous fat area(SFA),FPG,HDL and baPWV levels were all higher than those in the T2DM group,and the differences were statistically significant(P<0.05).(3)The prevalence of hypertension,proportion of drinkers,duration of diabetes,FPG,2-h postprandial blood glucose(2hPG),TyG,TG,Total cholesterol(TC)in G2 group were higher than those in G1 group.Fasting C-peptide(FCP),AST,Cr,UA in fasting C-peptide(FCP)group were lower than those in G1 group,with statistical significance(P<0.05).(4)Binary logistic regression analysis showed that age,SBP and LDL-C had statistical significance(P<0.05),the regression coefficients(B)of the three were positive,and the OR value was greater than 1.(5)Spearman correlation analysis showed that S-TBA was positively correlated with age,ALT,AST and TyG,and negatively correlated with HbAlc and Cr(P<0.05).(6)Fasting insulin(FINS),FCP,TyG,VFA,SFA,BMI,WC,ALT,AST,and prevalence of hyper LDL-C were significantly different between groups according to the S-TBA quartile(P<0.05).Conclusions:(1)Compared with T2DM group,T2DM patients with CAS were older,had a longer course of disease,and had more preexisting coronary heart disease,hypertension,and obesity.But there was no significant difference in S-TBA level between the two groups.Old age,elevated SBP and elevated LDL-C were risk factors for T2DM with CAS.(2)S-TBA level was positively correlated with age,ALT,AST and TyG level;And HbAlc,Cr levels were negatively correlated.(3)With the increase of S-TBA,the level of insulin resistance increased,the prevalence of hypertriglyceridemia increased,the prevalence of high LDL-C decreased,... |
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