| ObjectiveTo observe the relationship between homocysteine(Hcy) and serum cystatin C(Cys C)and high sensitive C reactive protein(hs-CRP) levels in elderly type 2 diabetes mellitus with carotid atherosclerosis.MethodsSelect elderly patients with T2 DM 108 cases from march 2013 to march 2014 in our hospital, male 76 cases, female 32 cases, the average age(75.6 ± 6.4) years, these patients as group T2 DM, according to the carotid artery intima-media thickness(IMT) were divided into IMT normal group and IMT thickening group,while over the same period in our hospital were randomly selected healthy 32 cases as control groups,male 20 cases,female 12 cases, the average age(74.9±6.8)years. All subjects will be grouped according to the presence of plaque formation separately(Plaque group),and record the Crouse integral. Statistical analysis the difference of IMT, Hcy, Cys C, Hs-CRP, total cholesterol(TC), blood lipid(TG), high density lipoprotein cholesterol(HDL-c), low density lipoprotein cholesterol(LDL-C), fasting blood glucose(FPG), 2 h postprandial blood glucose(2h Glu), glycosylated hemoglobin(Hb A1c), folic acid(FA), vitamin B12(Vit B12), systolic blood pressure(SBP), diastolic blood pressure(DBP), body mass index(BMI) between T2 DM group and the control,also applied to the IMT normal group and IMT thickening group.Statistical analysis of the correlation between Hcy,Cys C,Hs-CRPand IMT.Statistical analysis of the correlation between Hcy,Cys C,Hs-CRPand crouse integral.And analysis the risk factors of carotid atherosclerosis of patients with T2 DM.Results1.In group T2 DM, Hcy, hs-CRP, Cys C, IMT, LDL-C, 2h Glu, Hb A1 c, TG, FPG were significantly higher than that of control group(all p<0.05), FA, HDL-c lower than the control group.2.IMT thickening group Hcy, hs-CRP, Cys C and IMT was significantly higher than the normal group(p<0.001), FA level is lower than the normal IMT group(p<0.05).3.Correlation analysis showed that IMT and Hcy, hs-CRP, Cys C, LDL-c, FPG, HBA1 C and 2h Glu positive correlation, negative correlation with HDL-C, had no correlation with age, BMI, gender, blood pressure, TC and TG. Plasma level of Hcy was negatively correlated with FA and not correlated with VB12, Cys C levels and hs-CRP, 2h Glu, Hb A1 c levels correlated.4. In 87 cases of plaque group,the crouse integral of subjects was 1.4-23.4 points, the average score was 8.6 points, further, the Crouse integral is set as the dependent variable, Hcy,hs-CRP, Cys C levels were set as independentvariables, the multivariate linear regression analysis, found that there was a significant positive correlation between plasma Hcy, hs-CRP,Cys C levels and Crouse integral of the research object, p<0.01.5. Logistic regression analysis showed that Homocysteine, hs-CRP and Cys C are independent risk factors in elderly patients with type 2 diabetes carotid intimal thickening.6. The positive rate of elderly patients with type 2 diabetes mellitus group Hcy and Cys C and Hs-CRP and IMT were 63.9%,67.6%,76.9% and 51.9%, the combined detection of the positive rate increased to 92.1%,four positive indicators of diabetes group and control group,the difference was statistically significant.ConclusionThere is a close relationship p between cystatin C and Hcy and high sensitive C reactive protein on the occurrence and development of carotid atherosclerosis in elderly patients with type 2 diabetes, and can predict the severity of carotid atherosclerosis. Cys C, Hcy, hs-CRP and IMT of carotid artery, the four indicators of combined detection can greatly improve the detection rate of atherosclerosis in elderly type 2 diabetes, which has a positive significance for its early discovery. |
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