Correlation Analysis Between Serum Betatrophin Level And Carotid Intima-media Thickness In Patients With Type 2 Diabetes Mellitus

ObjectiveMacroangiopathy has become the leading cause of death in type 2 diabetes patients.As one of the important mechanisms of macroangiopathy,atherosclerosis is very common and can result in cardiovascular diseases.Thickening of the carotid intima-media thickness(CIMT)is one of the early criteria for atherosclerosis.Betatrophin,a newly-identified secreted protein in recent years,plays an important role in insulin resistance and metabolism of glycolipids,which are the important factors for atherosclerosis.The aim of our research is to observe the changes of serum betatrophin level and carotid intima-media thickness in type 2 diabetes mellitus patients and analyze the correlation.MethodsA total of 200 subjects were enrolled in this study.According to the CIMT,the subjects were divided into two groups,patients with normal CIMT(n=100,CIMT<1.0mm)and patients with thickening CIMT(n=100,CIMT?1.0mm).A standard questionnaire,anthropometric characteristics include body height,weight and blood pressure were conducted by trained study personnel.Oral glucose tolerance test(OGTT)and insulin releasing test were performed.Blood sample was collected in all of the participants to measure serum glucose and insulin.Total cholesterol(TC),triglyceride(TG),high-density lipids cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and other biochemical parameters were also detected.Serum betatrophin level was detected by enzyme-linked immunosorbent assay(ELISA).Results(1)Compared with the normal CIMT group,age,disease duration,BMI,waist circumference(WC),systolic blood pressure(SBP),fast insulin(FINS),insulin resistance index(HOMA-IR),hemoglobinA1c(HbA1c)and TG were significantly increased in T2 DM patients with thickening CIMT(P<0.05 or P<0.01).(2)The serum betatrophin level in T2 DM patients with thickening CIMT was significantly higher than the normal CIMT group(P<0.001).(3)All T2 DM patients were divided into three groups according to the serum betatrophin level,Terl group(betatrophin<0.409pg/L),Ter2 group(betatrophin 0.409~0.754pg/L)and Ter3 group(betatrophin>0.754pg/L).There were significant differences in age,disease duration,SBP,FPG,FINS,HOMA-IR,HbA1 c,TG,TC and CIMT among the three groups(P<0.05 or P<0.01).Compared to Terl group,the levels of FPG,HOMA-IR and CIMT in Ter2 group and Ter3 group were significantly increased(P<0.05 or P<0.01).The levels of age,disease duration,SBP,2hPG,FINS,HbA1 c,and TG in Ter3 group were significantly higher than those in Ter 1 group(P<0.05 or P<0.01).Age,disease duration,SBP,FINS,HOMA-IR,TG,and CIMT levels in Ter3 group were significantly higher than those in Ter2 group(P<0.05 or P<0.01).(4)Correlation analysis showed that serum betatrophin level was positively correlated with age,disease duration,SBP,FPG,2hPG,FINS,HOMA-IR,HbA1 c,and TG in T2 DM patients(r=0.326,0.167,0.230,0.347,0.159,0.302,0.436,0.329,0.348,P<0.05 or P<0.01).There was a significant positive correlation between CIMT and age,disease duration,body weight,WC,WHR,BMI,SBP,HOMA-IR,HbA1 c,TG,and betatrophin in patients with T2DM(r=0.580,0.365,0.181,0.279,0.175,0.170,0.248,0.252,0.193,0.218,0.408,P<0.05 or P<0.01).(5)Multiple stepwise regression analysis showed that age,betatrophin,and body weight were independent risk factors for CIMT.(6)Binary logistic regression analysis showed that betatrophin was significantly associated with CIMT even adjustment for age,disease duration,SBP,HbA1 c,FINS,FPG,HOMA-IR,and TG.Betatrophin was a risk factor of CIMT.Conclusions(1)Serum betatrophin level was significantly increased in T2 DM patients with thickening CIMT.(2)There was a significant positive correlation between serum betatrophin and CIMT in T2 DM patients;the increased of serum betatrophin result in the thickening CIMT.(3)Serum betatrophin may play an important role in the development of diabetic macrovascular complications.