Study On The Relationship Between IGFBP2 And Type 2 Diabetes Mellitus With Macroangiopathy

Objective:The prevalence of diabetes is increasing year by year,with an average of 1 in 10 adults suffering from diabetes,and the number of people suffering from diabetes in China is as high as 141 million.Diabetes has become a global killer,and its main cause of death is diabetic cardiovascular and cerebrovascular complications.Insulin like growth factor binding protein 2(IGFBP2)significantly enhances the ability of IGF-I to stimulate vascular smooth muscle cell proliferation.IGFBP2 has been shown to be associated with insulin sensitivity,blood lipid levels,and fatty liver,but no studies have yet shown relationship between IGFBP2 and diabetes-related macrovascular complications.In this study,we investigated the correlation between IGFBP2 and diabetic macroangiopathy by measuring serum IGFBP2 levels in type 2diabetic patients with different vascular lesions.Methods:1.We randomly selected 156 patients with T2 DM from January 2022 to December 2022 in the Department of Endocrinology and Metabolism,First Hospital of Jilin University.According to their vascular ultrasound findings,they were divided into 1)the group without vascular lesions(group A,52 cases)and 2)the group with vascular lesions(group B,104 cases).2.Detailed records of age,sex,height,weight,waist circumference,hip circumference,duration of diabetes mellitus,duration of hypertension,history of smoking,and history of alcohol consumption were recorded for all included patients.Fasting glucose,fasting C-peptide,total cholesterol,triglycerides,HDL cholesterol,LDL cholesterol,glycated hemoglobin,fatty liver,visceral fat and subcutaneous fat content were collected from patients at our clinical data center.Body mass index(BMI)= weight(kg)/weight(m)2;waist-hip ratio = waist circumference(cm)/hip circumference(cm);modified insulin function Homa-β = 0.27 × fasting C-peptide/(fasting glucose-3.5);modified insulin resistance index Homa-IR = 1.5 +fasting glucose × fasting C-peptide/2800.3.The serum IGFBP2 level,leptin level and lipocalin level were measured by enzyme-linked immunosorbent assay.4.Statistical software was applied for data analysis and processing.Categorical variables were expressed as the number of cases,and the chi-square test was used for comparison between groups,and the statistic was χ2;measurement data were tested by Shapiro-wilk normality test,and data conforming to normal distribution were expressed as mean ± standard deviation(± s),and the t-test was used for comparison between groups,and the statistic was t-value;non-normal data were expressed as median M(interquartile range IQR),and the Kruskal Wallis rank-sum test was used for comparison between groups,and the statistic was the z value.Logistic regression analysis was used for multifactorial analysis;ROC curves were applied to assess the clinical value of IGFBP2 in predicting the severity of macroangiopathy in T2 DM.All data were analyzed at P < 0.05 as statistically significant differences.Results:1.The differences were statistically significant(P < 0.05)between the T2 DM without macroangiopathy group and the T2 DM with macroangiopathy group in terms of history of hypertension,height,waist-to-hip ratio,duration of T2 DM,old age,Hb A1 c,Alb,TC,LDL-C,visceral fat content,IGFBP2;gender,history of smoking,history of alcohol consumption,weight,BMI,waist circumference,hip circumference,HDL-C,uric acid,subcutaneous fat content,leptin,lipocalin,FPG,FCP,Homa-β,Homa-IR,AST,ALT,TG,Cr,and fatty liver were not statistically significant between the two groups(P > 0.05).After multi-factor logistic regression analysis,there was no significant correlation between IGFBP2 and whether T2 DM was combined with macroangiopathy.2.When comparing the T2 DM mild vasculopathy group with the moderate to severe vasculopathy group,the differences in history of hypertension,height,waist-hip ratio,duration of T2 DM,old age,Hb A1 c,Alb,TC,LDL-C,visceral fat content,and IGFBP2 were statistically significant between the two groups(P < 0.05);gender,history of smoking,history of alcohol consumption,weight,BMI,waist circumference,hip circumference,HDL-C,uric acid,subcutaneous fat content,leptin,lipocalin,FPG,FCP,Homa-β,Homa-IR,AST,ALT,TG,Cr,and fatty liver were not statistically different between the two groups(P > 0.05).3.Multifactorial logistic regression analysis showed that IGFBP2 >152 ng/ml was a risk factor for more severe macroangiopathy in T2 DM.Conclusion:1.Serum IGFBP2 levels did not differ significantly between the development of macroangiopathy in T2 DM but were somewhat predictive of macroangiopathy severity.2.In patients with T2 DM combined with macroangiopathy,the degree of macroangiopathy was more severe with IGFBP2 > 152 ng/ml.