Analysis of influencing factors of carotid atherosclerosis plaque formation and stability in simple type 2 diabetic patients / 吉林大学学报(医学版)

ABSTRACT

Objective:To explore the related influencing factors of carotid atherosclerosis(AS)plaque formation and stability in the patients with type 2 diabetes mellitus(T2DM),and to provide scientific evidence for early prevention and treatment.Methods:A total of 249 cases of simple T2DM patients were selected.According to the results of carotid artery color Doppler ultrasound,they were divided into AS group,stable plaque group and unstable plaque group.The differences in physicochemical indexes and life style of the patients were compared between three groups;univariate analysis and Logistic regression analysis were used to screen the related influencing factors of carotid AS plaque formation and stability of the T2DM patients.Results:The univariate analysis showed that age,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),non-high density lipoprotein cholesterol (NHDL-C),monocyte/ high density lipoprotein ratio(MHR),smoking ratio(Smoking%),T2DM disease course,high density lipoprotein protein cholesterol(HDL-C)had significant differences between AS group and plague group(P<0.05).There were significant differences in the values of postprandial blood glucose(PBG), systolic blood pressure(SBP),low density lipoprotein cholesterol(LDL-C),HbA1c,MHR,Smoking% and HDL-C of the patients in stable plaque group and unstable plaque group(P<0.05).The Logistic regression analysis showed that high age,HbA1c,NHDL-C,MHR and smoking were the risk factors of the plaque formation and high HDL-C was a protective factor of plaque formation(AgeOR=1.62,P=0.011;HbA1cOR=1.25, P=0.027;HDL-COR=0.65,P=0.009;MHROR=3.50,P=0.000;SmokingOR=2.28,P=0.009;NHDL-COR=1.39,P=0.028).High SBP,LDL-C,MHR and smoking were the risk factors of unstable plaque formation,and high HDL-C was a protective factor of unstable plaque formation(SBPOR=1.5 7,P=0.003;LDL-COR=1.99,P=0.000;MHROR=3.88,P=0.000;SmokingOR=2.01,P=0.001;HDL-COR=0.53,P=0.001).Conclusion:For the patients with simple T2DM and carotid AS plaque,blood lipid,blood pressure and smoking cessation should be emphasized and HDL-C level should be increased,which can effectively prevent the formation of AS plaque and stabilize the plaque.