The Relationship Between Monocyte High-density Lipoprotein Ratio And Diabetic Atherosclerosis And Blood Stasis Syndrome

Purpose:To analyze the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR)and carotid atherosclerosis(AS)and blood stasis syndrome in patients with type 2 diabetes mellitus(T2DM),explore the clinical significance of MHR,predict the cut-off value of atherosclerosis risk in patients with type 2 diabetes mellitus,and provide objective clinical data for the early identification of atherosclerosis in patients with type 2 diabetes mellitus and the study of blood stasis syndrome.To reflect the concept of " prevention before disease onset,preventing disease from exacerbating " of traditional Chinese medicine.Material and method:269 patients in the Affiliated Hospital of Liaoning University of traditional Chinese medicine from January to December 2019 were analyzed.They were divided into control group(26 cases),DM alone group(100 cases),and DM combined AS group(143 cases)according to disease status;In the DM alone group,there were normal blood lipids(25 cases)and dyslipidemia group(75 cases);in the DM combined with AS group,there were no plaque subgroups(29 cases)and plaque subgroups(114 cases).Input data: age,gender,waist circumference(WC),body mass index(BMI),history of hypertension,smoking history,duration of diabetes,carotid intima-media thickness(IMT)and fasting plasma glucose(FPG),fasting C-peptide,C-reactive protein(CRP),monocyte count(MONO),blood lipid,glycated hemoglobin A1c(Hb A1c),and analysis according to the "Diagnostic Standard for Blood Stasis Syndrome" TCM syndrome types: 121 cases in the blood stasis syndrome group and 148 cases in the non-blood stasis syndrome group.The MHR value was calculated based on the first admission results of the hospital.The data of the three groups and the proportion of blood stasis syndrome were compared,and further analysis the relationship between MHR and blood stasis and the study on atherosclerosis stratification of type 2 diabetes mellitus.Statistical methods: spss26.0 was used,the measurement data were expressed by`x± s,the one-way ANOVA is used for the normal distribution,and the nonparametric test is used for the non normal distribution and the homogeneity of variance.The counting data were expressed in n(%),and ? 2 test was used.Spearman analyzed the correlation.ROC curve is used to analyze the predicted risk tangent value of MHR.P < 0.05 was considered statistically significant.Results:1.General data and laboratory indexes: there was no significant difference in gender,TG,TC,LDL-C and non-HDL among the subjects in each group(P > 0.05),smoking history(P < 0.05),and the proportion of hypertension,MHR,CRP and mono in three groups increased in turn,it was considered statistically significant(P < 0.01).Compared with the control group,the FPG level of DM group and DM combined with AS group increased,while the HDL-C level decreased(P < 0.01).Compared with the control group and DM group,DM combined with AS group was older,had longer course of diabetes and higher level of IMT(P < 0.01).Compared with DM group,there was no significant difference in WC,fasting C peptide and Hb A1 c in DM group and AS group(P > 0.05),BMI were higher(P < 0.05).2.Comparison of blood stasis syndrome proportion in three groups: the proportion of blood stasis in the control group(4 cases,15.38%),DM group(34 cases,34%),DM combined with as group(83 cases,58.04%)increased gradually,with statistically significant difference(P < 0.01).3.The relationship between blood stasis syndrome and MHR: compared with the non blood stasis group(0.33 ± 0.13),the MHR level of blood stasis group(0.37 ± 0.16)was higher,the difference was statistically significant(P < 0.05).4.Study on the relationship between MHR and atherosclerosis stratification in patients with type 2 diabetes mellitus: in DM group,the MHR level of DM group(0.34 ± 0.13)was higher than that in normal group(0.27 ± 0.08),with statistically significant difference(P < 0.01).Relationship between carotid atherosclerotic plaque and MHR: in DM combined with AS group,compared with the plaque group(0.40 ± 0.16)and the plaque free group(0.35 ± 0.15),the MHR in DM combined with as group increased,but there was no statistical significance(P > 0.05).5.Correlation analysis of MHR and IMT in type 2 diabetes mellitus patients: there was a linear correlation between MHR and IMT(r = 0.152,P < 0.05).6.ROC curve analysis: the cutoff value of MHR in predicting atherosclerosis in type 2 diabetic patients is 0.375,the sensitivity was 48.3%,the specificity was 78.6%,and the area under the curve was 0.668(95% CI: 0.605-0.732,P < 0.01).Conclusion:1.The occurrence of atherosclerosis in patients with type 2 diabetes mellitus is related to hypertension history,smoking history,age,diabetes course,BMI,CRP,MONO,MHR.2.Blood stasis exists in most type 2 diabetes mellitus and atherosclerosis patients,and the expression of MHR in blood stasis patients is increased.3.MHR has increased during the period of dyslipidemia in type 2 diabetic patients.4.IMT increased with the increase of MHR in type 2 diabetic patients.When MHR > 0.375,the risk of atherosclerosis increased in type 2 diabetic patients.