Correlation Between Glycated Albumin And Carotid Atherosclerosis In Patients With Type 2 Diabetes Mellitus

Objectives:To investigate the correlation between glycated albumin(GA)and carotid atherosclerosis,carotid intima-media thickness(CIMT),which is an index of early carotid atherosclerosis,in patients with type 2 diabetes mellitus(T2DM).Methods:This is a retrospective study.T2 DM patients aged 20 to 85 were selected as the subjects in the department of endocrinology of the First Affiliated Hospital of Fujian Medical University from December 2014 to February 2017.Collect all the subjects' gender,age and other basic information,GA,hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),2 hours plasma glucose(2hPG),fasting insulin(FINS),2 hours insulin(2hINS),fasting C peptide,2 hours C peptide,total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),serum creatinine,blood urea nitrogen,uric acid,and cystatin C,glomerular filtration rate(GFR),urinary albumin-to-creatinine ratio(ACR)and other data,as well as carotid duplex ultrasound results,including both sides' carotid intima-media thickness(CIMT)and carotid plaques.All data were analysed by statistical software SPSS 22.Divide the subjects into carotid atherosclerosis group and normal group to compare the clinical characteristics.The subjects were divided into good control group,general control group and poor control group according to the level of GA,to analyse the detection rates of carotid atherosclerosis and CIMT thickening of different GA control levels.Logistic regression analysis was applied to study the odds ratios of different GA control levels about carotid atherosclerosis and CIMT thickening.Simple correlation analysis and partial correlation analysis were applied to explore the correlation between GA and carotid atherosclerosis,CIMT thickening.The effects of GA and HbA1 c on carotid atherosclerosis and CIMT thickening were compared by Logistic regression analysis.Results:1.A total of 280 patients with T2DM(146 males and 143 females)were included in this study.The mean age of all subjects was(59.47±12.58)years,with a median DM duration of 9.0(3.6-13.0)years.204 cases of carotid atherosclerosis patients accounted for the total number of cases of 72.86%.The median GA of the carotid atherosclerosis group was 24(19.02-30.04)%,which was significantly higher than that of GA 20.37(17.18-25.23)%(P < 0.05)in the normal group.2.The rate of carotid atherosclerosis in good GA control group,general control group and poor control group was 61.8%,73.4% and 84.3%,respectively.The CIMT thickening rate of the three groups was 50.6%,62.5% and 69.3%,respectively.There was significant difference between the three groups in the rate of carotid atherosclerosis and CIMT thickening(P < 0.05).The rates of carotid atherosclerosis and CIMT thickening showed an increasing tendency from good control group to poor control group.Compared with good control of GA,the poor control and general control were independent risk factors of carotid atherosclerosis and CIMT thickening.3.Simple correlation analysis showed that carotid atherosclerosis and CIMT thickening were positively correlated with GA.Partial correlation analysis showed that in the control of sex,age and body mass index(BMI),carotid atherosclerosis and thickening of CIMT were positively correlated with GA(r=0.205,P=0.001;r=0.175,P=0.007);when controlling for smoking,HT,HDL-C,LDL-C,uric acid and other factors,carotid atherosclerosis was positively correlated with GA(r=0.200,P=0.038),and the correlation between CIMT thickening and GA disappeared(P > 0.05).4.Logistic regression analysis showed that GA was a risk factor for carotid atherosclerosis and CIMT thickening.When adjusting for gender,age and BMI,GA was an independent risk factor for carotid atherosclerosis and CIMT thickening.This association remained after adjusting for gender,age,BMI,smoking,HT,HDL-C,LDL-C,uric acid,and other factors.The results also indicated that HbA1 c was an independent risk factor for carotid atherosclerosis,and the OR of HbA1 c was higher than that of GA.Conclusions:Carotid atherosclerosis and CIMT thickening were positively correlated with GA in T2 DM patients.GA was an independent risk factor for carotid atherosclerosis and CIMT thickening.When evaluating the recent glycemic control in patients with T2 DM,GA also can predict the risk of carotid atherosclerosis,so as to better guide the treatment,to achieve the purpose of prevention and treatment of diabetic macrovascular disease.