Association Of Plasma Fetuin-A Levels With Lower Extremity Arterial Disease In Subjects With Type 2 Diabetes Mellitus

Objective:Study the association of insulin resistance,blood lipids,blood glucose,and ankle brachial index(ABI)with serum fetuin-A levels in the normal control group(group A),type 2 diabetes without lower extremity arterial disease group(B group)and type 2diabetic with lower extremity arterial disease group(group C).At the same time,to explore the influencing factors of ABI.Method:From March 2015 to December 2016 in our hospital medical center,Department of Endocrinology inpatient and outpatient,according to blood glucose,glycated hemoglobin,glucose tolerance test and ABI index of the patients were divided into 3 groups: normal control group(A group),a total of 31 cases of non diabetic lower extremity vascular disease group(B group),a total of 30 cases.Diabetic lower extremity vascular disease group(C group),a total of 35 cases.The measurement of blood pressure(BP),weight(BW),height(H),body mass index(BMI),at the same time,serum glucose(GLU),glycosylated hemoglobin(Hb Alc),triglyceride(TGCholesterol(TC),high density lipoprotein cholesterol(HDL),low density lipoprotein cholesterol(LDL),serum A levels were measured by enzyme-linked immunosorbent assay(ELISA).Result:(1)General condition of patients:In the 96 patients(Male 52 cases,Female 44 cases),mean age is 59.65± 4.23.Group A(30 cases),B group(31 cases),C group(35 cases)had no statistical difference inf age,gender,disease duration,DBP,height and weight.(2)In the group B and group C,the CRP?FPG?PPG?HbA1c?HOMA-IR?TG?TC?LDL?HDL were higher than in group A,except TG compared with normal control group,there is a statistically significant difference(P<0.05).Each index in group C is higher than in group A,except HbA1 c,the differences were significant(P<0.05).(3)The level of Fetuin-Ain the A,B,C three groups were(389.75±79.1)?(513.77±75.51)?(456.92±75.53)respectively,and there is a statistically significant difference(P<0.05).(4)The results of correlation analysis shows that serum Fetuin-A levels in A group is negatively correlated with age andthere is a statistically significant difference(P<0.05).In group B,serum Fetuin-A and body weight,BMI,PPG,HbA1 c,HOMA-IR,TG is positive correlation,but there is negative correlation with HDL,and there is a statistically significant difference(P<0.05).In group C,serum Fetuin-A is positively correlated with body weight,BMI,ABI,CRP,PPG,HbA1 c,HOMA-IR,TG,but there is a negative correlation with HDL and age,and there was statistical significance(P<0.05).(5)With the decrease of ABI in the C group,the level of serum Fetuin-A gradually decreased,and there was significant difference(P<0.05).Multivariate linear stepwise Regression analysis showed that Fetuin-A,HDL and SBP were independent factors of ABI.Conclusion:Type 2 diabetes lower limb vascular disease group and the group of lower extremity vascular disease in type 2 diabetes compared with normal control group,significantly higher levels of IR and serum fetuin A,suggesting that high levels of serum fetuin A is involved in the development of insulin resistance in diabetes mellitus,promote diabetes serum fetuin.A with lower extremity vascular disease in type 2diabetic patients with lower ABI value level gradually decreased,suggesting that low levels of serum fetuin A indicates that the diabetic lower extremity arterial disease,fetuin A may be involved in vascular calcification.