Relationship Between Serum GLP-1Levels And Subclinical Atherosclerosis In Newly Diagnosed Type2Diabetic Patients

Objective: Diabetes has become the increasingly serious social public healthproblem in the21st century. Chronic complications of type2diabetes mellitu（sT2DM）,especially macrovascular complication（cardiovascular, cerebrovascular and peripheralvascular diseases）is the major cause of disability and death of the diabetes patients. Aswe all known, atherosclerosis is the pathologic basis of the macroangiopathy. Theincrassation of the intima media thickness(IMT) appears earlier than the formation ofartery plaque and it is the prior evidence during the process of the atherosclerosis andformation of plaque. Glucagon-like peptide1(GLP-1), as an incretin hormone, hasshown its efficiency on glucose control. In spite of good effects of these drugs indiabetic patients, but the relationship between it and atherosclerosis is so little. Now wewill study the relationship of the serums GLP-1levels and sub clinical atherosclerosis inpatients in70cases of newly diagnosed type2diabetes.Patients and methods:1. Study samples:70cases with newly diagnosed T2DM admitted into theoutpatient of the endocrine in department of the First Affiliated Hospital of DalianMedical University from June2013to March2014were enrolled(male43,female27).DM diagnosis were according to1999WHO diagnostic standard of DM. The patientsaged25-70years old without the use of hypoglycemic drug treatment. All cases have noevidence of serious atherosclerosis in important artery, exclude type1diabetes andsecondary diabetes,no acute complications, no liver and kidney dysfunction, no tumerhistory, exclude history of pregnancy and lactation women.2. Grouping criteria: According to arterial intima-media thickness (IMT) measuredby color Doppler ultrasonography. Whose carotid arteries, femoral arteries IMT morethan1.0mm or local presence of atherosclerosis plague(DMA group,48cases),divided to the DMA1group (20cases), DMA2group (28cases);IDM group (22cases), whoseIMT of those two arteries were all less than1.0mm were divided, at the same time anormal contrast HC group (15cases) was set up.3. Research methods: Clinical data of70cases of type2diabetes through dietwithout drug therapy (height, weight, waist circumference, blood pressure, smokinghistory) and peripheral vein blood samples were collected. Biochemical detections(fasting blood glucose levels， Triglyceridemia， Cholesterolemia， Low-densitylipoprotein, High-density lipoprotein, blood uric acid, C peptide and glycosylatedhemoglobin) were also collected. Serum GLP-1levels were measured by ELISA.Results:1. Comparison of clinical data of each group: male proportion and smokerproportion in DMA2group and IDM group were higher than that of other two groups;Patient’s family history proportion in DMA1group was higher than that of the rest threegroups. The mean age of the patients with T2DM complicated with AS in DMA2groupand DMA1group was higher than that of IDM group and HC group; patients’ WClevels in three groups were higher than that of HC group（P＜0.05）. The mean values ofSBP, DBP, BMI in DMA2group, DMA1group and IDM group were higher than that ofHC group, but the differences among four groups had no statistical significance.2. FPG in three groups of DMA2group (9.55±2.63mmol/L), DMA1group(9.70±3.05mmol/L) and IDM group (11.59±3.41mmol/L) obviously increasedcompared with that of HC group (5.14±0.40mmol/L)（P＜0.05）. Serum GLP-1levelsin three groups of DMA2group (6.56±1.07pmol/L), DMA1group (6.21±0.82pmol/L)and IDM group (6.55±1.261pmol/L) were lower than that of HC group, but GLP-1levels of three groups had no difference.3. Pearson correlation analysis showed that serum GLP-1level was positivelyrelated with0hCP (r=0.383, P=0.001), and negatively related with FPG(r=-0.414,P<0.001), LDL-C(r=-0.428, P<0.001) and IMT (r=-0.318, P=0.007).4. Pearson correlation analysis showed that the IMT was positively related withFPG(r=0.536, P<0.001) and LDL-C(r=0.516, P<0.001), and negatively related with0hCP (r=0.385, P=0.007) and GLP-1(r=-0.526, P<0.001).5. Multiple linear regression analysis showed that FPG, LDL-C and GLP-1hadpredictive effect on the development of artery IMT in T2DM patients.Conclusions: 1. Patients with newly diagnosed type2diabetes mellitus have impaired secretionof serum GLP-1. Pancreatic B-cell dysfunction and elevated blood glucose of thesepatients may partly due to it.2. Serum GLP-1level is negatively related with IMT of arteries, and the reducingof serum GLP-1level may be one of the predictive factors of subclinical atherosclerosisin patient with T2DM. GLP-1may become a new target in prevention and treatment ofdiabetic macroangiopathy.