Shu Chen*, Yuanhang Bi1, Haozhe Fu*, Jinbao Li*, Weifeng Yu*, Xiaohui Luo**
*Department of Interventional and Vascular Surgery, Baoji Municipal Central Hospital - **Department of Urology, Baoji Municipal Central Hospital
Objective: To analyze the serum expression and clinical significance of plasma apolipoprotein M (ApoM) and retinol binding protein 4 (RBP4) in patients with type 2 diabetic carotid artery disease.
Methods: 110 patients treated with type 2 diabetes mellitus (T2DM) in our hospital endocrinology between September 2016 and September 2018 be chosen as the observation group, according to the results of carotid artery color doppler ultrasound, they would be divided into observation group of patients with carotid artery plaque group of 58 cases, normal group of 52 cases of their carotid arteries, while, 50 physical health cases would be chosen as control group, three groups of subjects in clinical general information collection, three groups of subjects was detected in serum ApoM, RBP4 levels, Meanwhile, subjects' fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and other biochemical levels were detected.
Results: Waist circumference and waist-hip in the carotid plaque group were significantly higher than those in the control group (P<0.05), and waist circumference in the normal carotid artery group was significantly higher than that in the control group (P<0.05). Serum ApoM in carotid plaque group was significantly lower than that in normal carotid group and control group (P<0.01), and serum ApoM in normal carotid group was significantly lower than that in control group (P<0.01). The serum RBP4 level of carotid plaque group was significantly higher than that of normal carotid artery group and control group (P<0.01). The levels of FBG, TC, TG and LDL-C in the carotid plaque group were significantly higher than those in the normal carotid artery group and the control group (P<0.01), and HDL-C were significantly lower than those in the normal carotid artery group and the control group (P<0.01). Serum ApoM was positively correlated with BMI (r=0.651, P<0.05), and negatively correlated with RBP4, FBG, TC, LDL-C levels (r=-0.257, -0.587, -0.532, -0.428, P<0.05). Serum RBP4 was negatively correlated with LDL-C (r=-0.334, P<0.05), and positively correlated with waist circumference, waist-hip ratio, TC, LDL-C, and BMI (r=0.286, 0.170, 0.210, 0.135, 0.339, P<0.05). Logistic regression analysis results showed that age, course of disease, LDL-C and serum ApoM and RBP4 levels were all risk factors affecting carotid artery lesions in type 2 diabetes mellitus (P<0.05).
Conclusion: Serum ApoM and RBP4 levels were decreased in T2DM patients with carotid artery vascular disease, and the mechanism of causing or aggravating vascular disease may be related to insulin resistance and dyslipidemia.
Plasma Apolipoprotein M, Retinol binding protein 4, Type 2 Diabetes, Carotid Angiopathy, Clinical Significance.