Analysis Of Correlations Between The Ratio Of Apolipoprotein B To Apolipoprotein A1 And Type 2 Diabetic Macrovascular Disease In Elderly People

Research BackgroundWith the development of economy and medical treatment,detection rate and morbidity rate of diabetes has increased by a large margin.Diabetes,a kind of chronic disease,and its complication has increasingly focused.Particularly,there is a high probability for the aged who has complex underlying health problems involved in diabetes and a serious of chronic complications,in which macrovascular diseases,such as stroke and myocardial infarction,are considered as main reasons leading disease and death.Atherosclerosis is a pathological basis of macrovascular complications and carotid atherosclerotic plaque with ulceration,rupture and loss is one of the important causes of ischemic stroke,and thus it is quite important to prevent carotid atherosclerotic plaque.Plenty of researches illustrate that the earliest stage of atherosclerotic plaque is the active oxidative stress in the arterial wall which promotes endothelial injury of type 2 diabetes mellitus.Subsequently,the insulin resistance syndrome associated with T2D(e.g.,hyperlipidemia and hypertension)speed the damage and aggravate disease especially all kinds of inflammatory metabolites are crucial causes to catalyze the atherosclerosis.An extensive research support that apolipoprotein A1(ApoA1)and apolipoprotein B(ApoB)are involved in the pathogenesis of diabetes and coronary heart disease(CHD),considering ApoB has effect of promoting atherosclerosis while ApoA1 has its antagonistic effect,and thus the main idea of this thesis adopts the ratio of ApoA1 between ApoB to analyze the correlations with the type 2 diabetic macrovascular disease.ObjectiveThis study investigated the relationship between the ratio of ApoB/ApoA1 and the occurrence of macroangiopathy in elderly type 2 diabetes by measuring and comparing the levels of ApoB/ApoA1 in elderly patients with type 2 diabetes combined with macrovascular disease and elderly patients with type 2 diabetes alone..Methods1.Select 102 patients who were hospitalized in the Department of Geriatric Endocrinology and Endocrinology of our hospital from March 2016 to September 2016 and met the following conditions: Group A: ≥ 65 years old,suffering from type 2 diabetes,and associated with large blood vessels Complications;Group B: ≥ 65 years old,suffering from type 2 diabetes,no diabetes-related complications,no cardiovascular and cerebrovascular related diseases.2.Each group were measured height and weight,fasts for 10-12 hours.Collect their elbow venous blood samples the next morning,and measures fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),and high density lipoprotein(HDL),low-density lipoprotein(LDL),glycosylated hemoglobin(HbA1c),apolipoprotein A1(ApoA1),apolipoprotein B(Apo B),and calculated for height and body mass index(BMI)and ApoB/ApoA1 ratio.3.After calibration of all data,SPSS 21.0 software was used for statistical analysis,P<0.05 was statistically significant.Results1.The average age of A group and ApoB/ApoA1 ratio in experimental group were higher than those in group B.The mean levels of HDL and ApoA1 in group A were lower than those in group B.The P values were all <0.05,and the difference was statistically significant.2.After correction of age confounding factors,A group ApoB / ApoA1 ratio was significantly higher than B group,P = 0.042(P <0.05),ApoA1 in group A was significantly lower than B group,P = 0.016(P <0.05),the difference Statistically significant.3.After adjustment for confounding factors,TC,TG,HDL,LDL,and ApoB were not significantly different between the two groups(P>0.05).4.Logistic regression analysis showed that the ratio of ApoA1 and ApoB/ApoA1 in elderly patients with type 2 diabetes was related to the occurrence of macrovascular disease.5.The ROC value for the ApoB/ApoA1 ratio is 0.68.Conclusions1.The ApoB/ApoA1 ratio is a risk factor for the development of macrovascular disease in elderly type 2 diabetic patients.ApoA1 is a protective factor.2.ApoB/ApoA1 ratio can significantly predict the risk of type 2 diabetes mellitus complicated with macrovascular disease,and it can be used as one of the independent risk factors of type 2 diabetes.It has certain value for predicting type 2 diabetes mellitus with macrovascular disease in the elderly people.3.The optimal cut-off value for the ApoB/ApoA1 ratio is 0.68,for patients with type 2 diabetes in the elderly,the ApoB/ApoA1 ratio is greater than 0.68 and there is a significant risk of major vascular complications.