The Changes Of Serum Chemerin Levels In Patients With Type 2diabetes Mellitus Complicated With Carotid Atherosclerosis

Objective:Diabetes mellitus is a common disease of endocrine system.It is caused by multiple etiologies and pathogenesis.It causes absolute or relative lack of insulin produced by the body,disorder of metabolism of carbohydrates,proteins and lipids,and is mainly featured by persistent increase in blood glucose.It hurts heart,kidney,eyes,and other parts of nervous system,in serious cases it will also endanger people's lives.In recent years,the number of people with diabetes in China has shown a clear trend of increase.One of the major complications of T2 DM is macrovascular disease,which brings great inconvenience to the daily life of patients,affects the quality of life of diabetics and increases their economic burden.The basic pathological change of macrovascular disease is atherosclerosis(AS).Compared with those with normal glucose tolerance,the morbidity possibility of AS in T2 DM patients is significantly higher.The purpose of this study is to provide a theoretical basis for the prevention and treatment of diabetes mellitus and its major vascular lesions by investigating changes in serum chemerin levels in T2 DM patients with CAS.Methods:1.Subjects: Select 60 cases of T2 DM patients diagnosed by our Department of Endocrinology from March 2016 to October 2017 as the experimental group.According to the results of carotid artery color Doppler ultrasound,T2 DM group was divided into CAS group and non-CAS group.In the same period,30 healthy people with matched gender and age were selected as the control group.2.Clinical data collection: Record the basic conditions of all groups of subjects,such as age,gender,duration,height,weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FPG),postprandial 2 hours blood glucose(2h PG),fasting insulin(FINS),hemoglobin A1c(HbA1c),and blood lipids;chemerin levels were determined by enzyme linked immunosorbent assay(ELISA).Results:1.The comparison of basic clinical indexes among the three groups:There was no significant difference in age,gender,BMI,SBP and DBP levels(P>0.05).Compared with NC group,FPG,2h PG,HbA1 c,FINS,HOMA-IR,TC levels in T2 DM group(with or without CAS group)were significantly higher(P<0.05 or P<0.01).The levels of TG and LDH-C in T2 DM with CAS group were significantly higher and HDL-C was decreased(P<0.05 or P<0.01).Compared with T2 DM without CAS group,the FINS,HOMA-IR,TG,and LDL-C levels in T2 DM with CAS group were significantly higher(P<0.05 or P<0.01),and HDL-C was significantly lower(P<0.05).There was no statistically difference in disease course,BMI,SBP,DBP,FPG,2h PG,HbA1 c and TC(P > 0.05).2.Comparison of chemerin levels between the three groups: Serum chemerin levels in the T2 DM group(with and without the CAS group)were significantly higher than those in the NC group [(1295.32±206.70)vs(1106.25±187.76)vs(985.56±151.58)pg/mL(P<0.01 or P<0.05)];The serum chemerin level of T2 DM with CAS group was significantly higher than that of T2 DM without CAS group(P<0.01).3.Correlation analysis of chemerin and various indicators:Spearman related analysis showed that serum chemerin in patients with T2 DM was positively correlated with disease duration,BMI,DBP,HbA1 c,FINS,HOMA-IR,TG and LDL-C(r=0.337,P=0.012),(r=0.363,P=0.006),(r=0.289,P=0.032),(r=0.270,P=0.046),(r=0.307,P=0.023),(r=0.541,P=0.001),(r=0.315,P=0.019),(r=0.290,P=0.032),negatively correlated with HDL-C(r=-0.313,P=0.020).There was no significant correlation with age,SBP,FPG,2h PG and TC.4.Logistic regression analysis: Logistic regression analysis showed that chemerin and LDL were independent risk factors for T2 DM complicated with CAS(OR: 1.007,95% CI: 1.001-1.012,P=0.017;OR: 3.887,95% CI: 1.288-11.726,P=0.016),HDL-C is an independent protective factor for T2 DM concurrent CAS(OR: 0.059,95% CI:0.005-0.672,P=0.023).Conclusion:The serum chemerin level of T2 DM patients were significantly higher than that of NC group,suggesting that it may be involved in the occurrence and development of T2 DM.The level of serum chemerin in patients with T2 DM and CAS were significantly higher than that in patients without T2 DM and CAS.Logistic regression analysis showed that chemerin and LDL were independent risk factors for T2 DM with CAS,and serum high levels of chemerin may be involved in diabetes and were relevant to the occurrence and development of vascular complications.3.Serum chemerin levels in patients with T2 DM were positively correlated with disease course,BMI,DBP,HbA1 c,FINS,HOMA-IR,TG,and LDL-C,negatively correlated with HDL-C,and not significantly related to age,SBP,FPG,2h PG and TC.Correlations suggest that chemerin may be influenced by insulin resistance,glucose,lipid metabolism and blood pressure regulation of the body,and changes of chemerin levels may be related to its involvement in the progression of atherosclerosis in diabetes and angiogenesis.