Diagnostic Value Of Serum Galectin-3、CXCL16 In Patients With Type 2 Diabetes Mellitus Complicated With Coronary Artery Disease

Objective:To investigate the levels of serum Galectin-3 and C-X-C chemokine ligand 16 (CXCL16), the correlationship between the level of serum Galectin-3 and high-sensitive C reactive protein (hs-CRP), the level of serum CXCL16 and hs-CRP. And to explore the diagnostic value of Galectin-3 and CXCL16 in patients with type 2 diabetes mellitus complicated with coronary artery disease.Methods:The study enrolled 30 patients with coronary artery disease (CAD group), 30 patients with type 2 diabetes mellitus complicated with coronary artery disease (T2DM-CAD group),30 patients with type 2 diabetes mellitus (T2DM group), and 30 healthy subjects with similar age and gender (Control group). The clinical data were collected. Serum Galectin-3 and CXCL16 levels were detected by enzyme linked immunosorbent assay. Serum hs-CRP level was detected by immunonephelometry method. Simultaneously, the serum levels of glucose (Glu), blood urea nitrogen (BUN), creatinine (CREA), uric acid (UA), triglyeride (TG) and total cholesterol (TC) were also detected by enzymic method; the serum levels of low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were detected by direct method. K-S test was used to judge normality of measurement data, Levene test was used to judge homogeneity of variance of more than three group measurement data, Kruskal-Wallis was used to analysis of variance was used to compare more than three group measurement data, Nemenyi test was used to compare two of several group measurement data, andχ2 test was used to compare several group count data. Pearson test was used for correlationship analysis between groups. A Multiple linear regression analysis was performed to determine which parameters were independent influencing factors of serum CXCL16 levels. Receiver operator characteristic curve(ROC curve) was used to evaluate diagnostic value of markers.Results:The major results are listed as follows:Part 1:Diagnostic value of serum Galectin-3 in patients with type 2 diabetes mellitus complicated with coronary artery disease Compared with the levels in the CAD group (7.417±1.797) mg/L and the T2DM group (6.515±1.499) mg/L, the levels of serum Galectin-3 in the T2DM-CAD group was significantly increased (10.523±4.552 mg/L, P<0.01). The levels of serum Galectin-3 in the CAD group and the T2DM group were markedly higher than Control group (4.050±0.953) mg/L. In T2DM-CAD group, the Galectin-3 was positively correlated to hs-CRP (r=0.724, P<0.001). In T2DM-CAD group/T2DM group, area under curve of ROC Curve of Galectin-3 was 0.859, Area under curve of hs-CRP was 0.842; no significant difference was found (z=0.245, P>0.05).Part 2:Serum CXCL16 as a Novel Biomarker of Coronary Artery Disease in Type 2 Diabetes Mellitus Compared with the levels in the CAD group (3.912±1.061) mg/L and the T2DM group (4.115±0.876) mg/L, the levels of serum CXCL16 in the T2DM-CAD group was significantly increased (5.707±1.404 mg/L, P<0.01). In the T2DM-CAD group, serum CXCL16 concentrations correlated positively with hs-CRP (r=0.772, P<0.001) and uric acid levels (r=0.476, P<0.01). Multiple linear regression analysis indicated that hs-CRP might be the only influencing factor for serum CXCL16 levels (β=0.772, P<0.001). Furthermore, in the T2DM-CAD group/T2DM group, the area under the curve of CXCL16 was 0.824, and the area under the curve of hs-CRP was 0.842; no significant difference was found (z=0.245, P>0.05).Conclusion:The main conclusions are listed as follow:1. Compared with separate CAD and T2DM patients, serum Galectin-3 expression levels in T2DM-CAD patients were significantly increased. It prompted that Galectin-3 was closely related to the development of T2DM-CAD;2. Serum Galectin-3 was significantly positively correlated with hs-CRP, and had the similar diagnostic performance with hs-CRP. It prompted the increased levels of serum Galectin-3 may has a certain diagnostic value to T2DM-CAD;3. Serum CXCL16 levels were markedly higher in patients with T2DM-CAD than in separate CAD and T2DM patients. It prompted that CXCL16 was involved in the development process of T2DM-CAD;4. Serum CXCL16 levels were positively associated with serum hs-CRP. Hs-CRP was an independent influencing factor of CXCL16. Similar to the diagnostic performance of hs-CRP, serum CXCL16 may also be a novel biomarker for the diagnosis of patients with CAD in T2DM.