Relationship Between Type 2 Diabetes Mellitus And Carotid Atherosclerosis With Serum C1q/tumor Necrosis Factor-related Protein 9

Objective: To investigate the relationship between type 2 diabetes mellitus(T2DM)and carotid atherosclerosis(CAS)with serum C1q/tumor necrosis factor-related protein 9(CTRP9).The correlation between CTRP9 and body fat parameters and glucose and lipid metabolism was analyzed,which provided a theoretical basis for clarifying the role of CTRP9 in the development of type 2 diabetes and carotid atherosclerosis.Methods: 112 patients with T2 DM were divided into two groups according to the results of color Doppler ultrasound examination of bilateral carotid artery: T2 DM combined CAS group(CAS group,56 cases)and T2 DM group(NAS group,56 cases);56 healthy individuals were served as controls(NC group,56 cases).Height,weight,blood pressure,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),hypersensitivity C-reactive protein(hsCRP),insulin(FINS)and glycosylated hemoglobin(HbAlc)were determined;meanwhile,body mass index(BMI)and insulin resistance index(HOMA-IR)were calculated in all subjects.Double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to detect serum CTRP9 concentrations in all subjects.Results:(1)The serum CTRP9 levels in CAS group and NAS group were lower than those in NGT group [(37.61�9.87),(53.51�10.76)vs(91.71�24.83)pg/mL](P<0.01),The serum CTRP9 level in CAS group was lower than that in NAS group [(37.61�9.87)vs(53.51�10.76)pg/mL](P<0.05).(2)Partial correlation analysis controlling age and gender showed that serum CTRP9 levels were positively correlated with HDL-C(r=0.176;P<0.05);and negatively correlated with disease duration,SBP,FPG,FIns,HOMA-IR,and HbA1C(r=-0.308,-0.209,-0.227,-0.241,-0.210,-0.419;P < 0.01).(3)Multiple linear stepwise regression analysis found that: HbA1 C and disease duration are independent influencing factors of serum CTRP9 level.(4)Logistic regression analysis showed that disease duration and hsC-RP were independent risk factors of CAS,and CTRP9 was an independent protective factor of CAS.Conclusion:(1)Compared with the normal control group,serum CTRP9 levels in CAS group and NAS group were significantly lower,and CTRP9 was negatively correlated with FPG,FIns,HOMA-IR,and HbA1 C.These results indicate that the decrease of CTRP9 level may be associated with the occurrence and development of diabetes mellitus.CTRP9 may play a protective role in the occurrence and development of type 2 diabetes.(2)The serum CTRP9 levels in NAS group was decreased,which was further decreased in CAS,suggesting that the decrease of serum CTRP9 level may be involved in the development of atherosclerosis in T2 DM patients.CTRP9 may play a protective role in the development and progression of carotid atherosclerosis in T2 DM patients,suggesting that serum CTRP9 levels may be an early indicator of carotid atherosclerosis in T2 DM patients.(3)The level of serum CTRP9 was positively correlated with HDL-C and negatively correlated with the course of disease,SBP,FPG,FIns,HOMA-IR,HbA1 C.HbA1C and duration were independent influence factors of serum CTRP9 level,suggesting CTRP9 level are closely related with blood pressure,blood glucose and blood lipids.