Relationship Of Chemerin And Soluble P-selectin With Peripheral Vascular Disease In Type 2 Diabetes Patients

Objective:To toinvestigate the association of chemerin and soluble p-selectin levels to lower extremity vascular disease in 2TDM, provide new theoretical basis for the diagnosis and treatment of type 2 diabetes lower limb artery. At the same time research cut-off value of using the ankle brachial index to diagnosis of type 2 diabetes lower limb artery lesions.Methods:1. Random selection of the inpatient and outpatient service in patients with type 2 diabetes (diagnosis accord with the WHO diagnostic criteria in 1999) in 90 cases of the Affiliated Hospital of North Sichuan Medical College in January 2013-November 2014. According to the result of doppler ultrasound, type 2 diabetes mellitus group was divided into not associated with type 2 diabetes lower limb vascular lesion group (NPAD group) 30 cases and type 2 diabetes group (PAD) with lower extremity vascular lesions group 60 cases. According to the disease severity,with lower extremity vascular lesions with diabetes group was divided into mild, moderate and severe three subgroups. At the same time choosing the healthy control group (healthy group) 30 cases of the hospital physical examination center healthy check-up.2. Using enzyme-linked immunosorbent assay (ELISA) to detect the chemerin and soluble p-selection levels of the research object. Collecting the object of study general data and determinating of biological information and ABI.Results:1. The chemerin compared among the three group, PAD group was higher than NPAD group (P< 0.05), NPAD group was higher than PAD group (P<0.05)the soluble p-selection among the three group, PAD group was higher than NPAD group (P< 0.05), NPAD group was higher than PAD group (P< 0.05). ABI comparative analysis results of PAD and NPAD group suggest PAD ABI level below the NPAD group, with statistical significance (P<0.05).2. The PAD group, NPAD group and healthy group, comparised between two groups, age, FPG and HbAlc, hypersensitive c-reactive protein exist significant difference, statistically difference (P< 0.05). Compared with healthy group, PAD group and NPAD group significantly increased total cholesterol levels, the difference was statistically significant (P<0.05)3. Among subgroups, HbA1c and age had no statistical difference (P> 0.05).Comparerd the soluble p-selectin levels among the three subgroups,P3 and P2 group is significantly higher than PI and health group,the difference was statistically significant (P<0.05). the soluble p-selectin levels was no significant statistical difference between P3 and P2 groups, but P 3 levels was higher than P2. Comparerd the chemerin levels among the three subgroups, P3 and P2 group is significantly higher than Pland health group, the difference was statistically significant (P<0.05). the chemerin levels was no significant statistical difference between P3 and P2 groups, but P3 levels was higher than P2.4. According to vascular colour to exceed diagnose PAD for reference standards, obtained by the ROC curve, that the cut-off value was 0.95 of using ABI to diagnose PAD. ABI diagnosis PAD specificity of 90%, sensitivity was 86.7%. Ankle brachial index and the choice of chemerin, soluble p-selection is negative correlation.5. Linear correlation analysis showed that chemerin level and total cholesterol, hs-crp,were positively correlated. Soluble select element is closely relative to course of the disease and HbAlc. chemerin and soluble p-selectin is closely relative. Logistic analysis showed that diabetes independent risk factors for lower limb artery vascular lesions are course, hs-CRP, total cholesterol, soluble p-selection, fasting blood sugar.Conclusion:1. Chemerin and diabetic lower limb artery lesions have association, choose P may has a certain significance in the development of diabetic lower extremity artery lesions occur.2. This study thinks that Soluble choose P may be risk factors of diabetes and PAD, and be closely related to the severity PAD. It still needs to further research Whether or not exist synergy about chemerin and soluble choose P in the diabetic lower extremity arterial lesions.3. This study concluded that ABI less than 0.95 is cut-off value of diagn-osis of lower limb vascular lesions,the results may be affected by small sample sizes.