| Objective:Macroangiopathy is one of major complications and causes of death of type 2diabetes mellitus, which seriously reduced the quality of life of diabetic patients, and increases their economic burden. Atherosclerosis(AS) is the basic pathological change of macroangiopathy. Individuals with diabetes have a greater risk of atherosclerosis compared to individuals without diabetes. Irisin, an exercise-induced myokine, potential adipokine, is considered to be associated with obesity, insulin resistance, glucose and lipid metabolism, metabolic syndrome, and so on. However, the relevant clinical research between irisin and diabetic macroangiopathy was little reported. The purpose of our study is to determine serum irisin level of type 2 diabetic patients with carotid atherosclerosis(CAS), type 2 diabetic patients without CAS, and to investigate the relationship between serum irisin and CAS in type 2 diabetic patients, aim to provide theoretical basis for the pathogenesis, prophylaxis and treatment of diabetic macroangiopathy.Methods:A totle of 60 cases of diagnosed type 2 diabetic patients from June 2014 to December2015 in the department of endocrinology in Second Hospital of Shanxi Medical University were included as the case group, and were futher divided into T2 DM with carotid atherosclerosis(CAS) group(30 cases) and T2 DM without CAS group(30 cases)according to the results of carotid colour ultrasonography; over the same period, 30 cases of healthy subjects, whoes gender and age is mached with the case group, in our hospital medical center were included as the normal control(NC) group. The age, gender, course of the subjects in our study were recorded; height, weight, systolic blood pressure(SBP) and diastolic blood pressure(DBP) were measured; fasting plasma glucose(FPG), blood lipid,glycosylated hemoglobin A1c(Hb A1c), fasting insulin(FINS) were measured; serum irisin level was determined by enzyme-linked immunosorbent assay(ELISA).Results:1. The comparison of basic clinical indexes among the three groups: The gender, age,total cholesterol(TC) were no siginificant difference among the three groups(P>0.05).Compared with the NC group, body mass index(BMI), FPG, Hb A1 c, FINS,Homeostasis model assessment of insulin resistane(HOMA-IR), low-density lipoprotein cholesterol(LDL-C) of T2 DM group were significant increased(P<0.05 or P<0.01),high-density lipoprotein cholesterol(HDL-C) of T2 DM group was significant decreased;SBP, DBP, triglyeeride(TG) of T2 DM without CAS group was significant increased(P<0.05 or P<0.01).Compared with T2 DM without CAS group, FINS of T2 DM with CAS group was significant increased(P<0.01), HDL-C of T2 DM with CAS group was significant decreased(P<0.01), course, BMI, FPG, Hb A1 c, HOMA-IR, LDL-C, SBP, DBP were no siginificant difference between T2 DM without CAS and T2 DM with CAS groups.2. The comparison of irisin levels among the three groups: The serum irisin levels were significantly decreased in the T2 DM group(T2DM with CAS and the T2 DM without CAS groups) compared to NC group [(3.33±0.95) vs(4.03±0.58) vs(4.50±1.56)ug/m L](P<0.01 or P<0.05)], and it was lower obviously in the CAS group than in the T2 DM without CAS group(P<0.01).3. The correlation analysis between irisin and each index: Spearman correlation analysis showed that the irisin level was negatively correlated with HOMA-IR, course(r=-0.312, P=0.015),(r=-0.321, P=0.013), and was positively correlated with HDL-C,DBP(r=0.321, P=0.012),(r=0.285, P=0.027), there was no significant relationship between irisin and age, BMI, FPG, Hb A1 c, FINS, TC, TG, SBP, LDL-C in type 2 diabetic patients.4. Logistic regression analysis: irisin and HDL-C were the independent protective factor for CAS(OR: 0.294, 95%Cl: 0.089-0.972, P=0.045),(OR: 0.013, 95%Cl:0.000-0.431, P=0.015).Conclusion:1. The serum irisin level was significantly decreased in the T2 DM group compared to NC group, suggesting that irisin may be associated with the occurrence and development of T2 DM.2. The serum irisin level was lower obviously in the T2 DM with CAS group than in the T2 DM without CAS group, Logistic regression analysis showed that irisin was the independent protective factor for CAS, suggesting that depressed serum irisin level may be one of the causes of occurrence and development of macroangiopathy in T2 DM.3. The irisin level was negatively correlated with HOMA-IR, course, and was positively correlated with HDL-C, DBP, suggesting that irisin may participate in insulin resistance, lipids metabolism and blood pressure regulation, serum irisin level may decreases gradually along with the development of diabetes duration, these may be related to that irisin participate in the pathological process of atherosclerosis in diabetic patients. |
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