| Objective: To explore the relationship of serum soluble costimulatory molecule CD40 L,PD-1,B7-H3 and type 2 diabetic with carotid atherosclerosis by comparing its changes in type 2 diabetic patients with and without carotid atherosclerosis and the controls,as well as to explore whether serum soluble costimulatory molecule CD40 L,PD-1,B7H3 can be used as a monitoring index fortype 2 diabetic with carotid atherosclerosis.Materials and Method: 89 Patients(65 males,25 females,average age 57.09±12.09 years,range: 33-84 years)with type 2 diabetes(T2DM)and 70 sex and age matched non type 2 diabetic(NT2DM)controls(50 males,20 females,average age 54.50±13.62 years,range: 33-87 years)were enrolled.All subjects had a carotid artery color Doppler ultrasound examination,and the intimal-media thickness(IMT)of the bilateral carotid artery was measured to determine the presence of atherosclerotic disease.Crouse score was used to qualify the disease burden.According to the ultrasound results,all enrolled subjects were further divided into four groups: type 2 diabetes with atherosclerosis(T2DM-CAS,n=49)?type 2 diabetes without atherosclerosis(T2DM-NCAS,n = 40)?non type 2 diabetes with atherosclerosis(NT2DM-CAS,n=37)and non type 2 diabetes without atherosclerosis(NT2DM-NCAS,n = 33).Subjects' sex,age,smoking history,height,weight,waist and hip circumference,blood pressure(systolic pressure SBP,diastolic pressure DBP)were recorded and body mass index was also calculated.Fastingbloodglucose(FBG),glycosylated hemoglobin(Hb A1c),triglycerides(TG),cholesterol(TC),low density lipoprotein(LDL-c),high density lipoprotein(HDL-c),high-sensitivity C reactive protein(hs-CRP)and fibrinogen(FIB)were also obtained.Enzyme-linked immunosorbent assay(ELISA)was used to measure the level of serum soluble costimulatory molecule,including CD40 L,PD-1 and B7-H3.Results:1.The serum s CD40 L level in the T2DM-NCAS group was significantly higher than it was in the NT2DM-NCAS group(P<0.01).The serum s CD40 L level in the NT2DM-CAS group was also significantly higher than the NT2DM-NCAS group(P<0.01).The serum s CD40 L level in the T2DM-CAS group was significantly higher than in the T2DM-NCAS group too(P<0.01).2.The serum s B7-H3 level in the T2 DM group was significantly higher than that in the NT2 DM group(P<0.01).The serum s B7-H3 level in the T2DM-NCAS group was significantly higher than in the NT2DM-NCAS group(P<0.01).The serum s B7-H3 level in the NT2DM-CAS group was significantly higher than in the NT2DM-NCAS group(P<0.01).3.The serum s PD-1level in the T2 DM groups was significantly higher than that in the NT2 DM group(P<0.01).The serum s PD-1 level in the T2DM-NCAS group was significantly higher than in the NT2DM-NCAS group(P<0.01).The serum s PD-1 level in the NT2DM-CAS group was significantly higher than in the NT2DM-NCAS group(P<0.01).The serum s PD-1 level in the T2DM-CAS group was significantly higher than in the T2DM-NCAS group(P<0.01).4.Theserum Hb A1 C level was significantly positive related s B7-H3 and s PD-1 in the T2DM-NCAS group.Crouse score was significantly positive related s B7-H3 in the NT2DM-CAS group.Crouse score was significantly positive related s B7-H3 in the T2DM-CAS group.5.Age,WHR,and s PD-1 were independent risk factors for carotid atherosclerosis in type 2 diabetic patients.6.ROC curve analysis showed that s PD-1,s B7-H3 have diagnostic value for type 2 diabetic patients with carotid atherosclerotic plaque(P<0.05);Area under the curve(AUC)of s PD-1was bigger than s B7-H3.Conclusions:1.The s CD40 L,s PD-1,s B7-H3 level is significantly elevated in type 2 diabetic patients without atherosclerosis,they may involved in the occurrence and development of the inflammatory process with diabetes.2.The s B7H3 and s PD-1 was positive correlated to blood glycosylated hemoglobin in type 2 diabetic patients without atherosclerosis,and s B7-H3 and s PD-1 may be used as an alternative index for monitoring patients blood glucose control state.3.The s CD40 L,s PD-1,s B7-H3 level is significantly elevated in nontype 2 diabetic patients with atherosclerosis,they may involve in the occurrence and development of the inflammatory process with atherosclerosis.4.The s B7-H3 level was positive related with crouse score in type 2 diabetic patients with atherosclerosis and non type 2 diabetic patients with atherosclerosis,s B7-H3 can be considered as a severity evaluation index of atherosclerosis.5.The s PD-1 level may be the independent risk factors for carotid atherosclerosis in type 2 diabetic patients.6.Thes PD-1 and s B7-H3 level have diagnostic value for carotid atherosclerotic plaque in patients with type 2 diabetes mellitus,and the diagnostic ability of s PD-1 is may be better than that of s B7-H3. |
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