Relationship Between The Levels Of Serum Asprosin And Carotid Intima-media Thickness In Patients With Type 2 Diabetes Mellitus

ObjectiveDiabetic macroangiopathy is the main cause of type 2 diabetes(T2DM)disability and death.Insulin resistance and glucose and lipid metabolism disorders are important factors influencing its occurrence and development.Carotid intima-media thickness(CIMT)thickening is often used as one of the main indicators for evaluating macrovascular disease in T2 DM patients.Asprosin is a novel adipokine closely related to insulin resistance and glycolipid metabolism discovered in recent years.At present,the relationship between serum asprosin level and CIMT thickening in T2 DM patients is not clear,so this study intends to explore the relationship between serum asprosin and CIMT in T2 DM patients,in order to provide a new clinical basis for the prevention and early diagnosis and treatment of diabetic macroangiopathy.MethodsA total of 230 patients with T2 DM who were treated in the Department of Endocrinology and Metabolism of our hospital from August 2016 to August 2019 were selected.According to the 2011 Guideline for Ultrasound Examination of Vascular and Superficial Organs,they were divided into T2 DM combined with CIMT thickening group(CIMT≥1.0 mm)patients in 102 cases,CIMT normal group(CIMT<1.0 mm)patients in 128 cases.Measure the basic parameters and biochemical indicators of the research subject,and use the ELISA method to detect the serum asprosin concentration of the subjects.The differences in general clinical data between the two groups were compared,the correlation between serum asprosin levels and various clinical indicators was analyzed,and Logistic regression was used to analyze the influencing factors of CIMT thickening.Results(1)Compared with CIMT normal group,the age,disease duration,body mass index(BMI),waist circumference,hip circumference,systolic blood pressure(SBP),fasting insulin(FIns),C peptide index(CPI),insulin resistance index(HOMA-IR)of patients with T2 DM combined with CIMT thickening increased significantly;Apo A(Apo A)decreased significantly(P<0.05).(2)T2DM combined with CIMT thickening group had higher serum asprosin levels than CIMT normal group(P<0.01).(3)According to serum asprosin levels,quartile grouping: Q1 group(asprosin<1.40 ng/m L),Q2 group(asprosin 1.40-1.79 ng/m L),Q3 group(asprosin 1.80-2.52 ng/m L),Q4 group(asprosin>2.52 ng/m L).Compared with Q1 group,CIMT in Q2 and Q4 groups was significantly thicker(P<0.05 or P<0.01);atherosclerosis index(AIP)in Q3 group was significantly increased(P<0.01);hip circumference,BMI and diastolic blood pressure(DBP)in Q4 group increased significantly(P<0.05).Compared with the Q2 group,the DBP of Q3 and Q4 groups increased significantly(P<0.05 or P<0.01),and the differences were statistically significant.(4)Correlation analysis results showed that serum asprosin levels was positively correlated to CIMT,body weight,hip circumference,BMI,DBP,triacylglycerol(TG),AIP,FIns,fasting C peptide(FC-P),and CPI(P<0.05 or P<0.01);negatively correlated with high-density lipoprotein cholesterol(HDL-C)and Apo A(P<0.05 or P<0.01).CIMT in T2 DM patients was positively correlated with asprosin,age,course of disease,weight,neck circumference,waist circumference,hip circumference,BMI and SBP(P<0.05 or P<0.01).(5)Taking CIMT as the dependent variable and other clinical indicators such as serum asprosin as independent variables,multiple stepwise regression analysis was performed.The results showed that serum asprosin levels,age,gender and BMI of T2 DM patients were the influencing factors of CIMT thickening(P<0.05 or P<0.01).(6)Binary logistic regression analysis was performed with CIMT thickening as the dependent variable(thickness=1,no thickening=0).The results showed that after adjusting for age,gender,course of disease,BMI,history of hypertension,smoking history,Hb A1 c,serum asprosin level was still an independent risk factor for CIMT thickening in T2 DM patients(P<0.05 or P<0.01).ConclusionElevated serum asprosin level was a risk factor for CIMT thickening in T2 DM patients,suggesting that asprosin might play a role in the occurrence and development of CIMT thickening in T2 DM patients.