| Objective: To characterize the risk parameters of type 2 diabetes with coronary atherosclerosis,and to identify the role of YKL-40,IL-6 and HCY in early detection and prevention of peripheral vascular disease in type 2 diabetic patients with coronary atherosclerosis.Methods:We collected 90 patients with diabetes type 2 who were Inpatient treatment in the Department of Endocrinology from December 2021 to October 2022,and divided them into three groups: type 2 diabetes group(T2DM-A,IMT thickness <1.0 mm),type 2 diabetes with carotid intima-media thickening(T2DM-B,1.0 mm≤ IMT thickness<1.5 mm)and type 2 diabetes mellitus with carotid plaque formation(T2DM-C,IMT thickness>1.5 mm),with 30 patients in each group.Other indicators were measured by our laboratory,including glucose metabolism and insulin indexes: FPG,HbAlc and FINS;lipid metabolism indexes: LDL-C,TC,HDL-C and TG,and HOMA-IR and BMI according to the calculation formula.The levels of YKL-40,IL-6 and HCY in the serum of each subject were measured by ELISA.The results of each index were compared between groups,and the changes of YKL-40,IL-6 and HCY levels between groups and the correlation with other indexes wereanalyzed.Finally,The data were statistically processed using SPSS25.0statistical software.Results:(1)Comparison between groups of the three factors:IL-6,YKL-40and HCY were the lowest in the diabetic group,the highest in the diabetic combined with AS group,followed by the sclerosis group in this study,and the differences were significant between the groups(p<0.05).(2)The results of pearson correlation analysis between serum YKL-40,IL-6,HCY and other indicators showed that there was no correlation between YKL-40,IL-6 and HCY factors and IMT with age,gender and SBP in this study population(P>0.05).In addition,serum YKL-40 levels were positively correlated with DBP,BMI,and ITM(r=0.368,r=0.282,r=0.748,P<0.05);and with glucose metabolism and insulin resistance indicators FINS,HOMA-IR,HbA1c,and FPG(r=0.579,r=0.645,r=0.365,r=0.619,P<0.05);positive correlation with lipid metabolism indexes LDL-C,TC,TG(r=0.562,r=0.525,r=0.226,P<0.05);positive correlation with both IL-6 and HCY(r=0.691,r=0.578,P<0.05);no correlation with HDL-C(P>0.05).Serum IL-6 levels were properly associated with DBP,BMI,and ITM(r=0.382,r=0.227,r=0.745,P<0.05);with glucose metabolism and insulin resistance indexes FINS,HOMA-IR,HbA1c,and FPG(r=0.589,r=0.531,r=0.363,r=0.482,P<0.05);positively correlated with lipid metabolism indexes LDL-C,TC,TG(r=0.554,r=0.470,r=0.226,P<0.05);properly associated with both YKL-40 and HCY(r=0.584,P<0.05);negatively correlated with HDL-C(r=-0.246,P<0.05);serum HCY levels were correlated with DBP,BMI,ITM were positively correlated(r=0.377,r=0.466,r=0.745,P<0.05);with glucose metabolism and insulin resistance indexes FINS,HOMA-IR,FPG were positively correlated(r=0.510,r=0.416,r=0.409,P<0.05);with lipid metabolism indexes TC,LDL-C,TG were positively(r=0.745,r=0.737,r=0.508,P<0.05);positive correlationwith YKL-40 and HCY;negative correlation with HDL-C(r=-0.325,P<0.05);no correlation with HbA1c(P>0.05).(3)Logist regression results suggest that YKL-40,IL-6,HCY and DBP are risk factors for peripheral vascular disease in combination with type 2 diabetes.Conclusions:(1)The occurrence of carotid plaque in type 2 diabetes in this study population may be associated with disturbances in glucose and lipid metabolism,elevated diastolic blood pressure and increased levels of YKL-40,IL-6 and HCY.(2)The expression levels of YKL-40,IL-6 and HCY are positively correlated and are jointly involved in the occurrence and development of atherosclerosis in type 2 diabetic patients.(3)Logistic regression results suggest that YKL-40,IL-6,HCY,and DBP are risk elements of atherosclerosis of the carotid artery in combination with type 2 diabetes. |
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