| ObjectiveThis study analyzed the relationship between the ratio of monocytes to highdensity lipoprotein cholesterol and carotid atherosclerosis with type 2 diabetes,evaluated the predictive value of MHR index detection in the diagnosis of T2 DM with CAS,and explored its clinical significance.It could provide relative safer and more reliable clinical biomarkers for the diagnosis and potential treatment strategies for cardiovascular complications in T2 DM,and provides some considering clinical evidence for solving the immune system inflammation intervention strategy in the future to reduce the risk of cardiovascular disease in type 2 diabetes mellitus.MethodsFrom January 2021 to July 2022 345 patients with type 2 diabetes were admitted to the endocrinology department of the First Affiliated Hospital of Dali University,at the mean while 129 patients with non-diabetic carotid atherosclerosis in the same period were selected enrolled in this study as well.According to the combination of carotid atherosclerosis,patients were divided into T2 DM with CAS group,type 2diabetes with normal carotid artery group and carotid atherosclerosis group.The clinical data including gender,age,monocyte count,LDL,FPG and FCP were collected,and MHR was calculated.SPSS 26.0 was used to analyze the clinical relationship between MHR and T2 DM with carotid atherosclerosis and its predictive diagnostic value.Graph Pad Prism 9.0 software was used for plotting.Results1.There were significant differences in age,BMI,SBP,MONO,BUN,Cr,MHR,HDL and LDL among the three groups.The course of DM,the incidence of HSI,DR,MHR,FPG and CAS in T2 DM group were higher than those in non-CAS group.3.Patients with T2 DM were divided into four groups according to the severity of CAS and the quartile of MHR.The incidence of CAS was significantly different among the four groups with different MHR levels.4.MHR was positively correlated with BMI,BUN,Cr,TG,LDL-C,FCP,hepatic steatosis index and HOMO-IR,and negatively correlated with TC and HDL-C.5.Logistic regression analysis was used to analyze the risk factors of CAS in T2 CAS in T2 DM.Increased age and higher systolic blood pressure,BMI,TG,LDL-C,MHR and HSI may be independent risk factors for carotid atherosclerosis in type 2diabetes mellitus.High levels of HDL in the physiological concentration range may be a protective factor.6.ROC curve was used to analyze the predictive value of MHR in the diagnosis of type 2 diabetes mellitus with carotid atherosclerosis: the area under the curve was0.708(P < 0.001).When MHR was 0.295,it may be the best critical value for the diagnosis of carotid atherosclerosis.Conclusion1.MHR is an independent risk factor for CAS with T2 DM.The incidence and severity of carotid atherosclerosis in T2 DM patients positively corelated to the variation of MHR level,and high levels of HDL in the physiological concentration range a protective factor.2.The accuracy of MHR in predicting whether type 2 diabetes mellitus is accompanied with carotid atherosclerosis is 70.8%.The sensitivity of MHR in predicting carotid atherosclerosis is 88.8 % and the specificity is 43.45%.Therefore,it is clinically possible to detect and calculate MHR regularly.The level has a certain value in predicting the occurrence of carotid atherosclerosis in T2 DM. |
