The Role of Monocyte to High-Density Lipoprotein Cholesterol Ratio in Prediction of Carotid Intima-Media Thickness in Patients With Type 2 Diabetes
The Role of Monocyte to High-Density Lipoprotein Cholesterol Ratio in Prediction of Carotid Intima-Media Thickness in Patients With Type 2 Diabetes
复制标题
单核细胞与高密度脂蛋白胆固醇比率在预测 2 型糖尿病患者颈动脉内膜中层厚度中的作用
DOI：
10.3389/fendo.2019.00191
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发表时间：
2019-04-04
影响因子：
5.2
通讯作者：
Wang, Xiao Qun
中科院分区：
文献类型：
--
作者：
Chen, Jia Wei;Li, Chang;Wang, Xiao Qun
背景资料：2型糖尿病（T2 DM）患者的慢性炎症性疾病和血脂异常是动脉粥样硬化性心血管疾病发展的重要因素。单核细胞与高密度脂蛋白胆固醇（HDL-C）的比值（MHR）是一种新的和简单的措施，正相关的身体炎症和氧化应激状态。然而，关于MHR在评价颈动脉内膜中层厚度（CIMT）中的作用知之甚少，CIMT是随后血管事件的替代预测因子，特别是在糖尿病患者中。方法：共有494例T2 DM患者和1，848例非糖尿病受试者连续入组研究1。比较糖尿病与非糖尿病患者MHR与CIMT的相关性。在研究2中，共入组了来自研究1的110例基础CIMT正常且在12个月时进行了随访超声检查的T2 DM患者。分析MHR对糖尿病患者CIMT进展的预测作用。结果：在研究1中，T2 DM患者的MHR高于非糖尿病受试者（p < 0.001）。在调整混杂风险因素后，糖尿病患者的MHR与CIMT仍显著相关（r = 0.172，p = 0.001），但非糖尿病患者的MHR与CIMT无显著相关（r = 0.006，p = 0.813）。Logistic回归分析表明，MHR与糖尿病患者CIMT升高相关性优于传统血脂指标（上级）。在研究2中，基线MHR与CIMT变化呈正相关（r = 0.313，p = 0.001）。在多变量线性回归分析中，基础MHR与CIMT变化独立相关[β = 0.059，（95% CI：0.012-0.105），p = 0.014]。结论：我们的研究表明，MHR是一个方便和有效的措施，在预测的存在和发展的亚临床颈动脉粥样硬化的T2 DM患者。
Background: Chronic inflammatory disorders and dyslipidemia in type 2 diabetes mellitus (T2DM) are essential contributors to the development of atherosclerotic cardiovascular disease. Monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel and simple measure associated positively with the body inflammatory and oxidative stress status. However, little is known regarding the role of MHR in evaluating carotid intima-media thickness (CIMT), a surrogate predictor of subsequent vascular events, especially in diabetic patients. Methods: A total of 494 patients with T2DM and 1,848 non-diabetic subjects were consecutively enrolled in study 1. Correlation between MHR and CIMT was compared between diabetic and non-diabetic subjects. In study 2, a total of 110 T2DM patients from study 1 with normal basal CIMT and a follow-up ultrasonography at 12 months were enrolled. The predictive role of MHR on CIMT progression in diabetic patients was analyzed. Results: In study 1, MHR was higher in patients with T2DM than non-diabetic subjects (p < 0.001). After adjustment for confounding risk factors, MHR remained correlated significantly with CIMT in diabetic (r = 0.172, p = 0.001) but not non-diabetic (r = 0.006, p = 0.813) subjects. Logistic regression analyses demonstrated that MHR is superior to traditional lipid parameters in association with elevated CIMT in diabetic patients. In study 2, MHR at baseline was positively correlated with change in CIMT (r = 0.313, p = 0.001). Basal MHR was independently associated with change in CIMT [β = 0.059, (95% CI: 0.012–0.105), p = 0.014] in multivariate linear regression analysis. Conclusions: Our study suggests that MHR is a convenient and effective measure in prediction of the presence and progression of subclinical carotid atherosclerosis in patients with T2DM.