Correlation Between Serum ILK Level And Carotid Atherosclerosis In Patients With T2DM

Objective:To study the correlation between serum ILK level and carotid atherosclerosis and plaque stability in patients with type 2 diabetes,to provide a new idea for the prevention and treatment of carotid atherosclerosis in patients with type 2 diabetes.Methods:A total of 252 patients with type 2 diabetes were recruted.All the patients were admitted in the Endocrinology of the Affiliated Hospital of Chengde Medical College during November 2019 to December 2020.There are 147 males and 105 females,aged 18-83 years.Collected the patient’s name,gender,age,weight,height,diabetes duration,systolic blood pressure(SBP),diastolic blood pressure(DBP),and other general information.The fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),uric acid(UA),high-density lipoprotein(HDL-C),low density lipoprotein(LDL-C),fasting C peptide(0 hc peptide)and blood routine tests were mesured.The ratio of Neutrophil-to-lymphocyte(NLR)、 monocyte-to-lymphocyte(MLR)and piatelet-to-lymphocyte ratio(PLR)were calculated.Carotid artery color Doppler ultrasound was done for all the patients.The fasting serum ILK concentration was determined by enzyme-linked immunosorbent assay(ELISA).According to the results of carotid artery ultrasound,patients were divided into normal group and carotid atherosclerosis group.The correlation between serum ILK level and carotid atherosclerosis was analyzed.The carotid atherosclerosis group was divided into plaque formation group and stenosis group.The baseline data and serum ILK level between subgroups were compared.The carotid plaque formation group was divided into stable plaque group and unstable plaque group according to the results of carotid artery ultrasound.The correlation between serum ILK level and plaque stability was further analyzed.Our sdudy aimed to investigate the correlation between serum ILK level and carotid atherosclerosis,plaque stability in patients with type 2 diabetes mellitus.Results:1.Comparison of baseline data,biochemical indexes and serum ILK among groups:Compared with the normal group,the carotid atherosclerosis group had older age [41(32,49)vs 60(52,65),P < 0.001],longer duration of diabetes[4.00(0.58,8.25)vs 10.00(5.00,17.00),P < 0.001],higher SBP [125(115,137)vs 140(127,155),P < 0.001],higher Hb A1 c level [9.80(8.20,11.35)vs9.10(7.90,10.10),P=0.01],and higher PLR level [131.00(100.32,179.45)vs117.30(91.62,149.30),P=0.042].There were no significant differences in BMI,DBP,lipid metabolism-related indexes,NLR and MLR.The serum ILK level was significantly decreased [45.12(26.44,55.40)vs 18.82(14.23,24.64),P < 0.001] in carotid arherosclerosis group.Compared with the plaque formation group,the carotid stenosis group had older age [58(51,65)vs 62(51,65),P < 0.04],longer duration of diabetes [10.00(3.75,15.00)vs 12.00(7.00,19.00),P=0.013],and higher SBP [138(126,151)vs 147(130,166),P=0.006].BMI,DBP,lipid metabolism-related indexes,NLR,MLR and PLR had no significant differences.The serum ILK level was significantly decreased [21.29(15.72,29.08)vs 15.47(13.40,19.04),P < 0.001] in carotid arherosclerosis group.Compared with the stable plaque group,BMI in the plaque unstable group was significantly increased [24.61±3.80 vs.25.70±2.67,P=0.047].There were no significant differences in age,course of diabetes,SBP,TCH,HDL,MLR,NLR,PLR.Serum ILK level was significantly decreased in the unstable plaque group [23.22(17.27,31.97)vs 19.65(14.79,24.58),P=0.021].2.Correlation analysis: The duration of disease(RS =-0.227,P=0.002)was negatively correlated with serum ILK level,while there was no significant correlation between TCH,HDL-C,TG,LDL-C,MLR,NLR,PLR and serum ILK level.3.Logistic regression analysis of risk factors of carotid atherosclerosis and plaque stability: Carotid atherosclerosis was taken as the dependent variable,and different Logistic regression models were established.Model 1:serum ILK level was the independent variable;Model 2: Independent variables were serum ILK level,age,sex,smoking history,course of disease,Hb A1 c,BMI;Model 3: Independent variables were serum ILK level,age,sex,smoking history,course of disease,Hb A1 c,BMI,TCH,HDL-C,LDL-C,TG,MLR,NLR,PLR;Logistic regression results showed that serum ILK level was still a protective factor for carotid atherosclerosis after excluding the influence of traditional atherosclerotic risk factors on carotid atherosclerosis.The stability of carotid plaque was taken as the dependent variable,and different Logistic regression models were established.Model 1: The independent variable was serum ILK level;Model 2: Independent variables were serum ILK level,age,sex,smoking history,course of disease,Hb A1 c,BMI;Model 3: arguments for the serum level of ILK,age,sex,smoking history,course of diseases,Hb A1 c,BMI,TCH,TG,LDL-c,HDL-c,MLR,NLR,PLR,Logistic regression results shown: the exclusion of all other possible risk factors to artery plaque instability of carotid plaques,the influence of serum level of ILK is still unstable carotid plaques of protective factors.Conclusion:1.Serum ILK level decreased in T2 DM patients with carotid atherosclerosis,and ILK level was negatively correlated with carotid atherosclerosis;2.Compared with the stable plaque group,serum ILK levels were decreased in the unstable plaque group,and ILK levels were negatively correlated with plaque stability in patients with type 2 diabetes;3.Serum ILK level is a protective factor for carotid atherosclerosis and unstable plaques.