Study Of The Relationship Between Plasma Retinol-binding Protein 4 And Subclinical Atherosclerosis In Newly Diagnosed Type 2 Diabetics

Objective:To evaluate the relationship between the concentration of plasma retinol-binding protein 4 (RBP4) and subclinical atherosclerosis (subAS) in newly diagnosed type 2 diabetic (T2DM) patients.Methods:There were 217 T2DM patients in study whose age is from 35 to 70 years old and their duration of disease is less than 1 year. (1) The patients were divided into two groups based on subAS and their clinical features, metabolic indices were compared; (2) The patients were divided into three groups based on the concentrations of RBP4, and whose intima-media thickness of common carotid artery (CCA-IMT), intima-media thickness of common iliac artery (CIA-IMT), intima-media thickness of femoral artery (FA-IMT) and the occurrence of subAS were compared; (3) The patients were divided into three groups respectively based on the CCA-IMT, CIA-IMT, FA-IMT, and then plasma RBP4 were compared among these groups; (4) The relevance of CCA-IMT,CIA-IMT,FA-IMT and other parameters were analyzed by Spearman correlation analysis respectively; (5) The relevance of RBP4 and other parameters were analyzed by Pearson correlation analysis; (6) The factors that can influence subAS in newly diagnosed type 2 diabetic patients were analyzed by Logistic regression analysis.Results:(1) The average age, FINS, HOMA-IR and plasma RBP4 concentration in subAS group were significantiy higher than non-subAS group; but there were no significant differences in other parameters such as blood glucose and so on between the two groups.(2) SBP of RBP4 high tertile group was significantly higher than low tertile group, FINS and HOMA-IR of RBP4 high tertile group were significantly higher than the low tertile group and middle tertile group; CCA-IMT, CIA-IMT and FA-IMT were increased with the increase of RBP4 concentration, CIA-IMT of RBP4 high tertile group was significantly thicker than the low tertile group and middle tertile group, there were no significant differences of CIA-IMT in RBP4 low tertile group and RBP4 middle tertile group. From RBP4 low tertile group to RBP4 high tertile group, the prevalence of subAS were increased from 14.5%,21.4% to 48.2%, respectively. The subAS prevalence of RBP4 high tertile group was significantly higher than the other two groups. There were no significant differences in other parameters such as blood glucose and so on in these groups.(3) Plasma RBP4 concentrations of CCA-IMT high tertile group was significantly higher than CCA-IMT low tertile group; plasma RBP4 concentrations of CIA-IMT high tertile group was significantly higher than CCA-IMT low tertile group and CCA-IMT middle tertile group. There were no differences in the three groups which were divided by FA-IMT.(4) It is showed by Spearman correlation analysis that the CCA-IMT of newly diagnosed T2DM patients is positively correlated with age, RBP4, FINS and LDL-C; the CIA-IMT of newly diagnosed T2DM patients was positively correlated with age, RBP4, TG and LDL-C; the FA-IMT of newly diagnosed T2DM patients was positively correlated with age and HbAlc.(5) It is showed by Pearson correlation analysis that the concentration of RBP4 in newly diagnosed T2DM patients is positively correlated with BMI, SBP, FBS, PBS, FINS and HOMA-IR.(6) It is showed by Mutiple stepwise Logistic regression analysis that subAS in newly diagnosed T2DM patients is related to plasma RBP4, age and LDL-c.Conclusion:1, SubAS in newly diagnosed T2DM patients is positively correlated with plasma RBP4 levels.2, High plasma RBP4 may be one of independent risk factors of subAS in newly diagnosed T2DM patients.