The Research Of The Relationship Between Perilipin 1 And Macroangiopathy In Type 2 Diabetes

Objective Type 2 diabetes mellitus has become one of the most challenging public health problems worldwide.In China,it is estimated that more than 100 million individuals are affected by diabetes.Diabetes can lead to serious pathological damage of numerous organs and tissues,among which macroangiopathies are the major causes of morbidity and mortality.Perilipins are the proteins associating with the lipid droplets in adipocytes and steroidogenic cells.Perilipin 1,an adipocyte-specific lipid-coated protein,may be involved in lipid metabolism homeostasis and inflammation.Recent studies have suggested that the perilipin 1 can cause intimal thickening and accelerate the formation of atherosclerosis,is an independent risk factor for atherosclerosis.But we know a little about it and other researchers have different viewpoints about it in the type 2 diabetes mellitus with macrovascular diseases.To research the correlation between perilipin 1 and type 2 diabetes mellitus and type 2 diabetes mellitus complicated with macrovascular disease.Methods 1.The study included 268 patients with type 2 diabetes mellitus who were admitted to the outpatient department and inpatient department of endocrinology,Danyang people's hospital.The patients were divided into type 2 diabetes group(nMVC)and type 2diabetes mellitus complicated with macrovascular disease group(MVC).Another 50 patients were randomly selected as the normal control group(NC group).2.Age,height,weight,waist circumference,hip circumference,systolic pressure,diastolic pressure,diabetes course,history,personal history,family history were recorded in detail.Olympus AU2700 automatic biochemical analyzer was used to detect fasting blood glucose(fasting plasma glucose,FBG),postprandial 2H glucose(postprandial 2H blood glucose,2hPBG),fasting insulin,triglyceride,total cholesterol,low density fat Low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(high-density lipoprotein cholesterol,HDL-C),alanine aminotransferase(alanine aminotransferase,ALT),aspartate aminotransferase(aspartate),creatinine,and creatinine E,Cr),urea nitrogen(urea nitrogen,BUN).All the above indexes were tested in the clinical laboratory of our hospital.The insulin resistance index(Homeostasis model assessment of insulin resistance,HOMA-IR),HOMA-IR =Fins(Uu/L))by the steady state model(HOMA)method were calculated.Philips' s HP5500 color ultrasound diagnostic apparatus was used to measure IMT.Enzyme-linked immunosorbent assay was used to determine serum perilipin 1 concentration.3.All data were processed with SPSS 22 statistical software package.The measurement data obeying normal distribution were represented by mean number +standard deviation(),and paired design t test was used to compare the effect beforeand after treatment;the measurement data disobeying the normal distribution were expressed in the median;the multi group ratio was compared with the variance analysis and the correlation variance.Pearson correlation analysis was used in the analysis.Spearman correlation analysis was used in the analysis of variance of correlation variance,and multiple factor analysis was analyzed by Logistic regression analysis.ROC analysis was used to predict the value of serum perilipin 1 for the diagnosis of T2 DM macroangiopathy.The best truncation point was selected and the area under the curve(AUC)was calculated to evaluate the diagnostic effect.With P<0.05 as a difference,there is statistical significance.Results 1.There was no significant difference in age,sex and diastolic pressure between the 3 groups(P>0.05),while smoking history,BMI,the course of diabetes and systolic pressure were compared,the difference was statistically significant(P<0.05).In the two groups,the smoking history,BMI,the course of diabetes and systolic pressure in the group MVC were higher than those of the nMVC group.The difference between group NC and group was statistically significant(P<0.05).2.There was no significant difference in the levels of AST,ALT,Cr,BUN and TG between the 3 groups(P>0.05).Compared with group NC,the FBG,2hPBG,HbA1 c,TC,LDL-C,perilipin 1 and HOMA-IR of group MVC and group nMVC were significantlyincreased,the difference was statistically significant(P<0.05).Compared with group NC,the level of HDL-C in group MVC and nMVC decreased significantly(P<0.05).Compared with group nMVC,there was no significant increase in TC level and no significant decrease in HDL-C level in group MVC(P>0.05).Compared with group nMVC,the levels of FBG,2hPBG,HbA1 c,LDL-C,perilipin 1 and HOMA-IR in group MVC were significantly higher than those in group A(P<0.05).3.Pearson linear correlation analysis shows that the level of perilipin 1 is positively correlated with systolic pressure(r = 0.27,P<0.01),FBG(r = 0.34,P<0.01),HbA1c(r =0.31,P<0.01),TC(r = 0.43,P<0.01),LDL-C(r = 0.47,P<0.01),HOMA-IR(r = 0.17,P =0.04),negatively correlated with HDL-C(r =-0.36,P<0.01).With perilipin 1 as the dependent variable,the multiple linear regression analysis was performed with the independent variables of systolic pressure,FBG,HbA1 c,TC,LDL-C,HOMA-IR and HDL-C.The results showed that HbA1 c,LDL-C and HOMA-IR were the risk factors of perilipin 1(the normalized regression coefficient = 0.33,0.23,0.25,P<0.05).4.Taking diabetic macroangiopathy as the dependent variable,with age,diabetes course,smoking history,systolic pressure,diastolic pressure,BMI,FBG,2hPBG,HbA1 c,TC,LDL-C,HDL-C,TG,perilipin 1,HOMA-IR as independent variables,Logistic multiple factor regression analysis was adopted.The results showed that HDL-C was a protective factor for large vascular lesions.HbA1 c,LDL-C,perilipin 1 and HOMA-IR are risk factors for diabetic macroangiopathy.5.The diagnostic criteria of T2 DM macroangiopathy in the inclusion criteria were used as the gold standard to diagnose 268 T2 DM patients.ROC curve was used to evaluate the accuracy of perilipin 1 in predicting T2 DM macroangiopathy.The results showed that the area under the ROC curve was 0.804,P <0.001.Conclusions 1.The level of serum perilipin 1 increased significantly in patients with T2 DM and T2 DM macroangiopathy,suggesting that perilipin 1 may be involved in the development of T2 DM and T2 DM macroangiopathy.2.Perilipin 1 level was positively correlated with systolic blood pressure,FBG,HbA1 c,TC,LDL-C and HOMA-IR,and negatively correlated with HDL-C.3.Serum perilipin 1 can be used as an independent risk factor for T2 DMmacroangiopathy and an effective monitoring index for T2 DM macroangiopathy.