| Objective:By observing the MHR(monocyte-to-highdensity lipoprotein ratio)in patients with type2 diabetes mellitus(T2DM),to discover the connection between MHR and SUA with carotid atherosclerosis in patients with T2 DM,so as to provide early intervention for T2 DM patients according to related risk factors.Methods:To choose 314 T2 DM patients which from October 2021 to September 2022,who were hospitalized in the endocrinology department of the affiliated some hospital as the research objects,and 168 physical examination people were selected as the control group.According to the results of carotid artery color Doppler ultrasound,the case group was divided into T2 DM carotid atherosclerosis group(n=266)and T2 DM carotid normal group(n=48).Logistic regression analysis was devoted to discuss the relationship between MHR and SUA with carotid atherosclerosis in patients with T2 DM.The case group was further divided into T2 DM with hyperuricemia group(n=92)and T2 DM with normal uric acid group(n=222)according to SUA level.Logistic regression analysis was devoted to discuss the relationship between MHR and SUA.Finally,ROC curve was applied to research in the diagnostic value of MHR,SUA and their combination in predicting carotid atherosclerosis in T2 DM patients.Results: 1.(1)The levels of age,SBP,FBG,Hb A1 c,TC,TG,LDL-C,Scr,SUA and MHR in T2 DM with carotid atherosclerosis group were higher than those in control group(P < 0.05).The level of HDL-C was lower than that of the control group(P < 0.05).(2)Age,SBP,TC,TG,LDL-C,MONO,Scr,SUA and MHR in T2 DM carotid atherosclerosis group were higher than those in T2 DM carotid normal group(P < 0.05).The level of HDL-C was lower in the T2 DM group than in the normal carotid artery group(P < 0.05).(3)The levels of age,SBP,FBG and Hb A1 c in T2 DM patients with normal carotid artery were higher than those in the control group(P < 0.05).2.Multivariate Logistic stepwise regression analysis showed that MONO(OR=2.04,95%CI: 1.21-3.45;P=0.007),age and TC were the risk factors of carotid atherosclerosis in T2 DM patients.HDL-C is a protective factor for carotid atherosclerosis in T2 DM patients.3.Logistic regression analysis of the relationship between MHR and SUA with carotid atherosclerosis in T2 DM patients showed that without adjusting for confounding factors,MHR(OR=2.23,95%CI: 1.46-3.39),SUA(OR=2.10,95%CI:1.39-3.19)were dangerous factors for carotid atherosclerosis in T2 DM patients(P < 0.05).After adjusting for gender,age,TC,HDL-C and MONO on the basis of model 1 and model 2,MHR and SUA were still dangerous factors for carotid atherosclerosis in T2 DM patients,and they could also be used as independent risk factors(P< 0.05).4.Grouping according to SUA level:comparison between T2 DM hyperuricemia group and T2 DM normal uric acid group: the levels of age,BMI,Hb A1 c,TC,TG,MONO,Scr,MHR and SUA in T2 DM which also were hyperuricemia group were higher than those in T2 DM normal uric acid group(P < 0.05);There was also a significant difference in gender between the two groups(P< 0.05).5.Multivariate Logistic stepwise regression analysis showed that Scr(OR=1.03,95%CI:1.01-1.05),TG(OR=1.36,95%CI: 1.08-1.71),BMI(OR=1.08,95%CI: 1.00-0.16)were the risk factors for hyperuricemia in T2 DM patients.Among T2 DM patients,female patients had a lower risk of hyperuricemia(OR=0.59,95%CI: 0.34-0.98),which could be regarded as a protective factor(P < 0.05).6.By establishing a model and adjusting related risk factors,Logistic regression analysis of the relationship between MHR and hyperuricemia in blood of T2 DM patients showed that MHR(OR=5.23,95%CI: 1.56-17.50)was a risk factor for hyperuricemia in T2 DM patients(P < 0.05);Taking Model 1 as the control group,after adjusting for gender and age,the risk of hyperuricemia in T2 DM patients in Model 2 was about 0.76 times that of Model 1(OR=4.00,95%CI: 1.14-13.99),the difference was statistically significant(P < 0.05),indicating that MHR was a risk factor for hyperuricemia in T2 DM patients.7.The results showed that:(1)The area under the curve of MHR alone in predicting carotid atherosclerosis in T2 DM was 0.72,the sensitivity was 69.17%,the specificity was 70.83%,the Youden index was 0.40,and the cut-off value was 0.35;(2)The area under the curve of SUA alone in predicting carotid atherosclerosis in T2 DM was 0.69,the sensitivity was 78.57%,the specificity was 60.42%,the Youden index was 0.39,and the cut-off value was 318.00.(3)The sensitivity,specificity,Youden index and AUC of MHR combined with SUA for predicting carotid atherosclerosis in T2 DM patients were 76.32%,75%,0.51 and 0.82,respectively.Conculsions:1.SUA and MHR are closely related to the occurrence of carotid atherosclerosis in T2 DM patients,and they are both independent risk factors for the occurrence of carotid atherosclerosis.2.MHR can be used as a risk factor for hyperuricemia in patients with T2 DM.3.In patients with T2 DM,both MHR and SUA can be used as predictors of carotid atherosclerosis,and the combination of MHR and SUA has a higher specificity for predicting carotid atherosclerosis in patients with T2 DM. |
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