| Objective:investigate the correlation between lipid indeces,e.g.non-HIGH-density lipoprotein(non-HDLC),and subclinical atherosclerosis(SAs)and unstable plaques in type 2 diabetes mellitus,so as to provide evidence for the prevention and treatment of macrovascular complications in type 2 diabetes mellitus.Methods:A total of 2,193 patients with type 2 diabetes in the Department of Endocrinology,Hefei First People’s Hospital from January 2010 to December 2016 were selected.Carotid artery ultrasound was used to measure the bilateral carotid artery intimal thickness(CIMT)and the bilateral carotid artery plaque.According to the color doppler ultrasound results,the patients were divided into normal group(809cases)、thickening group(223 cases)and plaque group(1161 cases),and The differences of clinical data,such as age,Blood Pressure,sex,smoking history,fatty liver and biochemical data,such as blood glucose and blood lipid,were compared among the three groups.Subjects with intimal thickening or plaque formation were further collected as the subclinical atherosclerosis(As)group,and the impacting factors of As were analyzed by binary Logistic regression.According to the risk stratification of LDLC in patients with T2DM,we divided LDLC into the meeting group and the undermeeting group.We compared the clinical data of the SAS group(1184 cases)and the normal group(643 cases)under the condition of substandard LDLC control in patients with T2DM,and analyzed the influencing factors of SAS using binary logistic regression.Based on ultrasonic measuring stability of plaque echo plaques can be divided into spot(590 cases)and unstable plaques(400 cases),study T2DM patients LDLC falls below,under the condition of single factor analysis of stable plaque group and unstable plaque group general clinical data comparison,the single factor analysis of meaningful variables combined with clinical experience think meaningful together into two categories in the Logistic regression,analysis the influence factors of unstable plaques.Results 1.The number of smokers,the number of subjects with family history of diabetes,the number of subjects with fatty livers,age,course of disease,BMI,systolic blood pressure,urea nitrogen,blood creatinine,blood uric acid,non-HDLC,TC,LDLC/HDLC and LDLC in the plaque group were significantly higher than those in the normal group(P<0.05).Age,course of disease,BMI,systolic blood pressure,urea nitrogen,and non-HDLC/HDLC in the thickening group were significantly higher than those in the normal groupwith statistically significant differences(P<0.05).Binary Logistic regression analysis showed age(OR=1.110,95%CI:1.095-1.125,P<0.05),course of disease(OR=1.003,95%CI:1.001～1.004,P<0.05),systolic blood pressure(OR=1.008,95%CI:1.002～1.015,P<0.05),non-HDLC(OR=1.203,95%CI:1.077～1.343,P<0.05)were independent risk factors for SAs,while HDLC(OR=0.073,95%CI:0.538～0.972,P<0.05)was a protective factor for SAs.2.When LDLC was not controlled to the standard in T2DM,the SAs group had higher age,systolic blood pressure,disease duration,BMI,fatty liver,urea nitrogen,serum creatinine,glycosylated hemoglobin,blood uric acid,non-HDLC,TC,LDLC/HDLC,LDLC,and family history than the normal group(P<;0.05),binary logistic regression analysis showed that gender,systolic blood pressure,age,course of disease and non-HDLC were independent risk factors for ASs(OR value was 1.921,1.009,1.116,1.003,2.330,P<;0.05).3.When LDLC was not controlled to the standard in T2DM patients,the number of people with smoking history,gender(female),family history,age,urea nitrogen,diastolic blood pressure,non-HDLC/HDLC,LDLC/HDLC,TG/HDLC were higher in the unstable plaque group,and the disease course of HDLC was lower.Binary regression analysis indicated that gender and non-HDLC were independent risk factors for unstable plaques(OR=1.676,3.875,P<0.05).Conclusion:Non-HDLC is a good lipid index for the evaluation of subclinical atherosclerosis in T2DM patients and a biomarker for the evaluation of unstable plaques in T2DM patients with substandard LDLC control. |
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