Association Between Serum Placental Growth Factor(PLGF) And Carotid Atherosclerosis In Patients With Type 2 Diabetes Mellitus

Objective:To investigate the serum PLGF levels in type 2 diabetes mellitus(T2DM) patients and to explore the relationship between PLGF and carotid atherosclerosis in patients with T2 DM. To provide certain theoretical basis on clarifying the role of PLGF in the formation of carotid artery plaque in T2 DM patients by analyzing the correlation of PLGF and glucolipid metabolism and inflammatory factor. To explore the possibility of PLGF as a new target spot for early diagnosis, intervention and treatment in T2 DM patients with macroangiopathy.Methods:53 Patients with T2 DM were divided into two groups according to the presence of carotid plaques:group T2DM+NAS(27 cases without carotid plague)and group T2DM+AS(26 cases with carotid plague). 26 healthy individuals were served as controls(group NC). Blood pressure, height, weight, fasting plasma glucose(FPG), total cholesterol(TC), triglycerides(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), glycosylated hemoglobin(Hb A1c), high sensitivity C-reactive protein(hs CRP), tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) were determined in all subjects. Body mass index(BMI) and homeostasis model assessment for insulin resistance index(HOMA-IR) were calculated. Serum PLGF levels were measured using ELISA kits.Results:(1)Both group T2DM+NAS and group T2DM+AS had significantly elevated serum PLGF levels(45.35±13.00,59.24±11.05)pg/m L relative to group NC(27.30±10.22)pg/m L(P<0.01). Group T2DM+AS showed significantly higher serum levels of PLGF compared to that of group T2DM+NAS(P<0.01).(2)Correlation analysis showed that serum PLGF was positively correlated with BMI、SBP、FPG、TC、TG、LDL-C、Hb A1c、hs CRP、TNF-α、IL-6 in all patients, and with TC、LDL-C、hs CRP、IL-6 in all type 2 diabetes patients(P<0.05).(3)Similarly, multiple regression analysis showed that LDL-C and IL-6 were the independent factors of serum PLGF level(P<0.05).(4)Furthermore, a significant positive correlation existed between the serum PLGF and carotid plague.Conclusion:(1) Serum PLGF level was remarkably increased in T2 DM patients, particularly in patients with carotid artery plaque, suggesting that PLGF might participate in the early formation of AS and promote the occurrence and development of atherosclerosis. It could be a useful marker of early diagnosis of carotid atherosclerosis in type 2 diabetic patients.(2) There existed a positive correlation between PLGF and hs CRP、TNF-α、IL-6, and IL-6 was the independent factor of serum PLGF level, which revealed that the function of PLGF to promote the occurrence and development of AS might to be achieved primarily through regulating inflammation.(3)Serum PLGF level was closely related to BMI, blood pressure, blood glucose and blood lipid, so good controlling of these may decrease the level of PLGF which possibly delay the progress of carotid atherosclerosis in T2 DM patients.