Research Of Subclinical Atherosclerosis In Type 2 Diabetic Patients With Metabolic Syndrome

Objective:The aim of this study was to find clinical evidences for the early diagnosis and management of macrovascular complications in Type 2 Diabetes Mellitus(T2DM) patients with or without metabolic syndrome (MS)through investigating the relationship between the concentration of mannose-binging lectin (MBL) , plasminogen activator inhibitor-1(PAI-1), high sensitive C-Reactive Protein(hs-CRP) and the value of ankle brachial indices (ABI) and subclinical atherosclerosis (As),and analyzing the risk factors of subclinical As in T2DM patients with MS.Method: 215 patients were divided into tow groups: 130 patients with MS (87patients with subclinical As,43 patients without subclinical As ) and 85 without MS(58 patients with subclinical As,27 patients without subclinical As). ELISA technique was employed to determine the concentration of MBL,PAI-1and hs-CRP;ABI were measured by Doppler ultrasound.The indexes were compared in groups and analyzed the relationship with sub-clinical As in the patients with T2DM and MS.Results:1.Compared with patients without subclinical As ,hs-CRP of patients with subclinical As was significantly higher (P=0.000),MBL and ABI was no significant difference(P>0.05) either patients with or without MS;PAI-1 was significantly higher(P=0.000)only in patients with MS. 2. Taking no account of subclinical As ,compared with patients without MS,MBL of patients with MS was significantly lower(P=0.000) , hs-CRP,PAI-1 was significantly higher(P=0.000 or P=0.001),ABI was no significant difference(P>0.05).3.Correlation analysis showed that hs-CRP,PAI-1,age, duration of diabetes, systolic pressure and Low-density lipoprotein (LDL) cholesterol was correlated positively with subclinical As. Multiple logistic regression analysis showed that hs-CRP, age and duration of diabetes were independently association with subclinical As.4.Carotid intima-media thickness(IMT),The prevalence of IMT≥1mm and atherosclerotic plaque did not differ significantly between diabetic patients with and without MS(P>0.05).Conclution:1. Low MBL may be a risk factor for As. 2.High hs-CRP and PAI-1 were correlated with Carotid As, may be regarded as sensitive index to predict subclinical As.3.The study showed that hs-CRP ,age and duration of diabetes were main risk factors for subclinical As of diabetic patients with MS.4. Compared with patients without MS,the patients with MS have more risk factors of As and showed an increasing trend of the incidence of carotid plaque,so active interference should be given.