Correlation Between Platelet /Lymphocyte And Carotid Plaque In Patients With Type 2 Diabetes In Different Age Groups

Objective: To explore the correlation between between PLR and T2 DM carotid plaque by detecting the platelet to lymphocyte ratio(PLR)in patients with type 2 diabetes mellitus(T2DM).and whether age has an impact on this correlation.Methods: Data were obtained from hospitalized patients diagnosed with T2 DM in the Department of Endocrinology,Gansu Provincial People's Hospital from June 2017 to September 2018.Patients were divided into low-age group(age <55 years old)153 cases and high age group(age?55 years old)by age: 138 cases of low-age group T2 DM with carotid plaque(carotid plaque,cIMT< 51 cases of 0.9mm or cIMT?0.9mm),102 cases of T2 DM without carotid plaque(cIMT<0.9mm without carotid plaque),86 cases of T2 DM with carotid plaque in high age group,T2 DM 52 cases of carotid plaque were combined.The PLR was divided into a low PLR group(PLR < 119.4)and a high PLR group(PLR?119.4)according to tertiles.Obtain general clinical data of patients by querying electronic medical records,including patient gender composition,age,and body mass index,SBP,DBP,pulse pressure,heart rate,duration of disease,smoking history and drinking history,carotid artery intima media thickness(cIMT),white blood cell count(WBC),neutrophil count,lymphocytes,mean platelet volume(MPV)platelet count(PLT),total cholesterol(TC),low-density lipoprotein(LDL-C),hypersensitive C-reactive protein(hs-CRP),high density lipoprotein(HDL-C),fasting plasma glucose(FPG),creatinine(Cr),uric acid(UA),FINS,HbA1 c,urinary albumin excretion rate(UAER)and other laboratory indicators;Calculatting the homeostasis model assessment of resistance(HOMA-IR),HOMA-IR = FINS × FPG / 22.5,PLR(platelet count / lymphocyte count),NLR(Neutrophil/lymphocyte count).The analysis was performed using SPSS 19.0 statistical software,and P value <0.05 represents comparative statistical difference.An independent sample t test was used to compare the two groups.Logistic regression analysis of risk factors for carotid plaque.Results: 1.Comparison of baseline data between low age group and high age group study: compared with subjects in the lower age group,Men,BMI,smoking history,drinking history,WBC,neutrophil count,lymphocyte count,FPG in high age group is reduct,P value<0.05.The history of hypertension,duration of disease,SBP,pulse pressure,PLR,and HDL-C in the high-age group were significantly higher than those in the low-age group,P value <0.05.2.no-plaque group and plaque group in low-age group: Compared with T2 DM patients without carotid plaque group,,male,history of hypertension,smoking history,drinking history,SBP,pulse pressure in T2 DM with plaque group were significantly increased,P value <0.05,PLR no difference between the two groups.3.Comparison of no-plaque group and plaque group in high-age group: compared with no carotid plaque group in T2 DM patients T2 DM combined with plaque group,smoking history,SBP,WBC,FPG,creatinine,uric acid,HOMA-IR,hs-CRP,cIMT were significantly increased,P value <0.05;plaque group lymphocytes and HDL-C were lower than those without plaque,P value <0.05;the plaque group PLR(130.21±47.07)was higher than the no-plaque PLR(111.96±35.33),P value <0.05.4.Analysis of risk factors for carotid plaque in low age group: T2 DM carotid plaque as a dependent variable,adjusting gender,hypertension,smoking,drinking,SBP,TC,LDL-C,hs-CRP factor,multivariate logistic regression analysis showed that SBP(OR=1.046,95% CI: 1.009-1.084,P=0.015)Smoking(OR=3.506,95% CI: 1.666-7.381,P=0.001),TC(OR=1.564,95% CI: 1.005-2.435,P=0.047)was a risk factor for carotid plaque formation.Correlation analysis of age group PLR and arterial plaque: spearman correlation analysis showed that there was a positive correlation between PLR and arterial plaque,r=0.181,p=0.033.6.Analysis of risk factors of carotid plaque in high age group: T2 DM carotid plaques were dependent variables,adjusting gender,history of hypertension,smoking history,TC,LDL-C,HDL-C,hs-CRP traditional arterial plaque risk factors,multivariate logistic regression analysis showed that males(OR =5.449,95% CI: 2.213-13.420,P=0.000),hypertension(OR=3.732,95% CI: 1.195-11.651,P=0.023),TC(OR=2.421,95% CI: 1.382-4.240,P=0.002)was a risk factor for carotid plaque formation;high PLR(OR=2.702,95% CI: 1.171-6.234,P=0.020)was a risk factor for carotid plaque;HDL-CConclusion: The correlation between high PLR and carotid plaque in patients with T2 DM is related to age.High PLR was an independent risk factor for carotid plaque in T2 DM patients in the high age group and was not associated with carotid plaque in patients with low age T2 DM.PLR may be a new biomarker for carotid plaque in elderly T2 DM,and this marker is cheap and easy to obtain,and can be widely used in clinical work.