| Objective Diabetic macrovascular complication as a major complication of type 2 diabetes mellitus (T2DM) is one of the most important reasons of disability or death in T2DM. A variety of mechanisms involved in its occurrence and development process have not been fully understood. It is confirmed that Apelin is related to sugar metabolism disorders and insulin resistance.So Apelin may be involved in the processes of incidence and development of diabetic macrovascular complication. This article aims at exploring the relationship between serum Apelin level and atherosclerosis in early type 2 diabetes, and to evaluate the correlation in Apelin,blood glucose, blood pressure, blood lipids, blood insulin, glycosylated hemoglobin (HbAlc), insulin resistance index (HOMA-IR) and weight index (BMI),et al. This study may provide the basis for further research on the role of Apelin in atherosclerotic occurrence and development in T2DM.Methods In accordance with diagnosis and recommended sub-type of diabetes mellitus of WHO in 1999, type 2 diabetes patients whose disease duration was less than 3 years were recruited. Their jugular artery,common iliac artery and femoral artery were examined using color Doppler ultrasonography. According to the results, the patients were divided into non-plaque group and plaque group. Whose artery intima-media thickness (IMT)≤1.3mm and no atherosclerotic plaque was detected in any part above were divided into the non-plaque group (n=30).The others were divided into diabetic plaque plaque group (n=30). Thirty-two age and sex-matched healthy controls were enrolled. General clinical parameters were measured and calculated, such as height, weight, waist circumference (W), hip circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI and waist-hip ratio (WHR).Besides routine biochemical examinations, including fasting plasma glucose (FPG), cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C) and low density lipoprotein (LDL-C), type 2 diabetes patients also need to exam HbAlc, fasting serum insulin (FINS),calculating HOMA-IR.Enzyme-liked immunosorbent assay was used to determine fasting serum Apelin levels of all the people. All the results were used for statistical analysis.Results 1. Serum Apelin levels in the patients with plaque was significantly higher than the normal control group (P<0.05).2. Serum Apelin levels in the patients with non-plaque was significantly higher than the normal control group (P<0.05).3. Serum Apelin levels in the non-plaque group were significantly higher than those in the plaque group (P<0.05).4. Correlation analysis results showed that the serum Apelin level was positively correlated to BMI, HbAlc, FBG, TC, LDL-C, FINS and HOMA-IR in diabetic patients(r=0.272,0.310,0.383,0.334,0.266,0.423,0.561, P <0.05).5. Serum Apelin as the dependent variable, age, W, WHR, BMI, SBP, DBP, HbAlc, TC, TG, HDL-C, LDL-C, FINS, HOMA-IR as independent variables for multiple stepwise regression analysis,the result showed that serum Apelin level was influenced mainly by HOMA-IR and TC independently.6. In accordance with plaques, the patients were divided into two groups for Logistic regression analysis. The result showed that, serum Apelin level was an independent risk factor of atherosclerosis in early type 2 diabetes patients,with the negative correlation between Apelin and atherosclerosis. (P<0.05).Conclusion 1. Serum Apelin level in early T2DM patients was significantly elevated, and serum Apelin level was related with obesity, insulin resistance, lipid metabolism disorder.2. Serum Apelin level in early T2DM patients with atherosclerosis is low. Low serum Apelin level may be a predictor of atherosclerosis, and Apelin may be an inhibitory factor for atherosclerosis.
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