The Correlation Between Serum GRB2 Levels And Carotid Atherosclerosis In Patients With Type 2 Diabetes Mellitus

Purpose: This was the first study to investigate blood GRB2 levels in type 2 diabetes mellitus(T2DM)patients with carotid atherosclerosis(CAS),exploring its relationship with various metabolic indicators,and further,examining whether GRB2 has an AS effect in patients with T2 DM.Methods: A total of 203 participants were recruited in the study,including 69 T2 DM patients without CAS(T2DM group),67 T2 DM patients with CAS(T2DM+CAS group),and67 in the age-sex-matched healthy subjects(Control group).Serum GRB2 levels were measured using enzyme-linked immunosorbent assay(ELISA)in 203 subjects who had received carotid ultrasonography.In addition,blood lipid,fasting plasma glucose(FPG),glycosylated hemoglobin(HBA1c),fasting insulin(FINS),hypersensitive C-reactive protein(hs-CRP),and Interleukin 6(IL-6)were also tested.The correlation between serum GRB2 levels and other indexes was analyzed.Finally,we analyzed the risk factors affecting carotid intima-media thickness(CIMT)in T2 DM patients.Results: 1.Serum GRB2 levels were increased in the T2 DM group than in the control group,and further elevated in the CAS group(median 3.05 vs 4.40 vs 7.09 ng/ml,P<0.001).2.Spearman correlation analysis showed that GRB2 concentrations were negatively correlated with HDL-C and TC,and positively associated with duration of diabetes,waist-tohip ratio(WHR),HBA1 c,FPG,FINS,homeostasis model assessment-insulin resistance index(HOMA-IR),hs-CRP,IL-6 and CIMT(P<0.01).3.Stepwise multiple linear regression analysis showed that IL-6,HDL-C,HBA1 c,and CIMT are independent correlation factors of serum GRB2(P<0.01).4.Univariate logistic regression suggested that disease duration,WHR,SBP,TG,HDL-C,HBA1 c,FPG,HOMA-IR,IL-6,Hs-CRP,and GRB2 independently associated with T2 DM is combined with CAS(P<0.05).And multivariate logistic regression analysis showed that duration of diabetes,IL-6,and serum GRB2 levels were independent risk factors for T2 DM combined with CAS(P<0.05).5.The ROC curve AUC area of serum GRB2 expression levels was 0.80(95%CI: 0.7291-0.8613,P < 0.001),with a sensitivity of 83.58% and specificity of 70.59%.The risk of CAS was substantially higher in patients with T2 DM whose serum GRB2 concentration was >4.59ng/ml.Conclusions: Serum GRB2 concentrations were higher in the T2 DM group compared to healthy subjects,and even higher in the T2DM+CAS group,and serum GRB2 levels were linearly correlated with CIMT,GRB2 may be implicated in the occurrence and progression of T2 DM with CAS.