The Correlation Between Endocan And Type 2 Diabetes Mellitus With Macrovascular Injury

Objective: To investigate the correlation between the serum level of endocan and T2 DM with macrovascular complications.Methods: From April 2015 and November 2015,A total of 102 patients with T2 DM were recruited from the department of Endocrinology in Gansu Provincial Hospital, all of the patients were devided into three groups based on the value of carotid intima-media thickness(cIMT), T2 DM group(cIMT<0.9mm without plaques, 42 subjects),T2 DM with macrovascular injury group(cIMT≥0.9mm without plaques, 32 subjects) and T2 DM with carotid artery plaque group( plaques with cIMT≥0.9mm or not, 28 subjects), 28 gender and age matched healthy subjects were used as the control group. The c IMT, Fasting blood glucose(FBG), Triglyceride(TG), Total cholesterol(TC), Low density lipoprotein cholesterol(LDL), High-density lipoprotein cholesterol(HDL), Fasting insulin(Fins), glycosylated hemoglobin(HbA1c), liver and kidney function, high-sensitivity c-reactive protein(hs-CRP) and the serum level of endocan were measured.Results: The serum level of endocan was significantly increased in the T2 DM group, T2 DM with macrovascular injury group and T2 DM with carotid artery plaque group as compared with the control group(all P<0.05),In addition, the serum level of endocan in T2 DM with macrovascular injury group and T2 DM with carotid artery plaque group were markedly higher than that in T2 DM group(P<0.05), whereas,there was no significant difference in the level of endocan between T2 DM with macrovascular injury group and T2 DM with carotid artery plaque group(P>0.05).The level of TG,FBG,HbA1 c and Homeostasis model assessment of insulin resistance(HOMA-IR) in three groups were significantly higher compared with that in control group(all P<0.05), The level of HDL in three groups were significantly lower than that in control group(all P<0.05). The level of hs-CRP was markedly increased in T2 DM with macrovascular injury group compared with that in control group(P<0.05). Pearson linear analysis showed that endocan was positively correlated with the course of disease, FBG, HbA1 c and c IMT(r=0.364, 0.181,0.238, 0.542, respectively, all P<0.05), In addition, cIMT was positively correlated with the Age, course of disease, systolic blood pressure, FBG, HbA1 c, HOMA-IR and the serum level of endocan(r=0.246, 0.284, 0.202, 0.213, 0.211, 0.177, 0.542, respectively, all P<0.05), but negatively correlated with HDL(r=-0.178, P<0.05). Multivariate linear stepwise regression analysis demonstrated that endocan, age, FBG and HDL were the independent risk factors for cIMT in patients with T2 DM, cIMT and the course of disease were the independent risk factors for endocan in patients with T2 DM. Logistic regression analysis showed that the serum level of endocan and HOMA-IR were the risk factors, whereas HDL was the protective factor for carotid artery plaque formation. The results of the ROC curve analysis for endocan revealed, an area of receiver operator characteristic curve(AUROC) of 0.888((95%CI0.825~0.950, P=0.000). This finding suggested that the serum level of endocan has a relative high accuracy in the diagnosis of T2 DM with macrovascular injury.Conclusions: Our findings suggested that the serum level of endocan was related to the macrovascular complications in T2 DM, it may be used as a novel biomarker for macrovascular injury of T2 DM. Further research is needed to investigate the mechanisms of endocan in the pathogenesis of macrovascular complications in T2 DM.