Relationship Between The Intima Media Thickness Of Common Carotid Artery (c-imt)and Adiponectin Level And Gene Polymorphism In Promoter Region In Patients With Metabolic Syndrome Accompanied With Type 2 Diabetes Mellitus

Objective To explore relationship between the intima media thickness of common carotid artery (C-IMT)and adiponectin level and gene polymorphism in promoter region in patients with metabolic syndrome (MS)accompanied with type 2 diabetes mellitus(T2DM).Methods 218 patients with metabolic syndrome accompanied type 2 diabetes mellitus, including 115 patients without incrassation of carotid artery IMT (MS1 group) and 103 patients with incrassation of carotid artery IMT (MS2 group) were enrolled in this study. Plasma adiponectin level (APN), fasting plasma glucose (FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1C), total cholesterol (TC), triglyceride (TG), high density lipoproteins (HDL-C), body height, weight, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP), carotid artery intima media thickness (CIMT) were measured. Low density lipoprotein (LDL-C), body mass index (BMI), waist to hip ratio (WHR), homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. The adiponectin gene SNP-11377C→G polymorphism was identified by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). The Hardy-Weinberg equilibrium was tested by Chi-square test of goodness of fit. and polymorphic frequencies were compared in MS1and MS2 groups. T test and Chi-square test was used to compare the differences between groups. The association of adiponectin and other factors were tested by stepwise multiple regression analysis.Results (1) Plasma adiponectin level (mg/L) was significantly lower in MS2 group than MS1 group (P<0.01) (6.63±3.87,7.93±3.80). Simple correlation analysis proved that plasma adiponectin level was negative correlated with CIMT (r=-0.207, P<0.01), HOMA-IR (r=-0.195, P<0.01) and CC+GG gene type (r=-0.151, P<0.05),but positively correlated with HDL-C (r=0.258, P<0.01). Stepwise multiple regression analysis proved that plasma adiponect in level was negatively correlated with CIMT and HOMA-IR, but positively correlated with HDL-C. (2) The frequencies of adiponectin gene genotype and allele showed significant difference between MS1 and MS2 groups (P<0.05). (3) Plasma adiponectin level, SBP, DBPand CIMT showed significant difference between CC and CG+GG groups (P<0.05).Conclusion Aggravation of arteriosclerosis accompanied descending adiponectin level in patients with metabolic syndrome accompanied with type 2 diabetes mellitus. There was significant association of SNP-11377C→G polymorphism in promoter region of adiponectin gene and the intima media thickness of common carotid artery in patients with metabolic syndrome accompanied with type 2 diabetes mellitus of Fujian.