Analysis Of Factors Related To Carotid Artery Atherosclerosis And Its Progression In Elderly Patients With Type 2 Diabetes Mellitus

Introduction: To analysis factors related to the carotid artery atherosclerosis and its progression in elderly patients with type 2 diabetes mellitus,and to provide evidence for clinical prevention and treatment.Methods: Four hundred diabetic patients age ≥ 65 were enrolled between June 2015 and June 2017 at three centers: the First Affiliated Hospital of China Medical University,Sheng Jing Hospital Affiliated to China Medical University and the First Affiliated Hospital of Dalian Medical University,and ninety-nine patients were willing to participate in the 1 year follow-up program.According to criteria of carotid plaque defined by the carotid Doppler ultrasound,all participants were assigned into carotid plaque group(N = 291)or non-plaque group(N = 109).Similarly,99 participants defined by the progression of carotid plaque into plaque progression group(N = 49)and non-progression group(N = 50).The differences of risk factors between the two groups were analyzed.Results: In the univariate analysis of this study,age,sex,total cholesterol(TC),non-HDL-C),creatinine(Cr),glomerular filtration rate(eGFR)and cystatin(Cys-C)were statistically significant different between the elderly diabetic plaque group and the non-plaque group included.In the logistic regression,age was shown to be an independent risk factor for carotid atherosclerosis in elderly diabetic patients(OR1.106,95%CI 1.069-1.143,P=0.001).In addition,there is a linear relationship between carotid plaque and age.Subgroup analysis of the study showed that serum Cys-C levels were significantly associated with progression of carotid atherosclerosis in participants(P = 0.041).Logistic regression analysis still shows that serum Cys-C is an independent risk factor for the progression of carotid atherosclerosis in elderly diabetic.(OR 3.037,95%CI 1.230-7.497,P=0.016).The risk of plaque progression increases with increasing levels of Cys-C.Conclusion: Age is an independent risk factor for elderly diabetic patients with carotid artery atherosclerosis,plaque load increases gradually with age increasing.Serum Cys-C level is an independent risk factor for the progression of carotid artery atherosclerosis in elderly diabetic patients.