The Relationship Between Serum Hcy,Lp(a)and 25(OH)D3 Levels and Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus and Hypertension
Objective To study the relationship of serum homocysteine(Hcy),lipoprotein(A)[Lp(a)]and 25-hydroxy vitamin D3[25(OH)D3]with carotid atherosclerosis in patients with type 2 diabetes mellitus(T2DM)complicated with hypertension.Methods 102 patients with T2DM and hypertension admitted from February,2020 to February,2023 were selected as the observation group,while 92 patients with T2DM alone during the same period were included in the control group 1,and 92 healthy people in the physical examination center were enrolled as the control group 2.According to carotid intima-media thickness(IMT)measured by ultrasound,patients in the observation group were divided into 65 cases in sclerosis group and 37 cases in non-sclerosis group.The general data[age,gender,disease duration,body mass index(BMI),blood pressure,presence of other underlying diseases(hyperlipidemia,coronary heart disease),smoking history,drinking history]and laboratory examination indicators[total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),Hcy,Lp(a),25(OH)D3,IMT]were compared among groups.Multivariate logistic regression analysis was used to identify the risk factors of carotid atherosclerosis in T2DM patients with hypertension.Pearson correlation analysis was applied to evaluate the relationship between serum Hcy,Lp(a),25(OH)D3 and IMT in patients with T2DM and hypertension.Receiver operating characteristic(ROC)curve was drawn to analyze the value of serum Hcy,Lp(a)and 25(OH)D3 on predicting carotid atherosclerosis in T2DM patients with hypertension.Results Levels of Hcy and Lp(a)and IMT in the observation group were higher or thicker than those in the control groups 1 and 2,while the level of 25(OH)D3 was lower than that in control groups 1 and 2(P＜0.05).Serum Hcy and Lp(a)levels and IMT in the sclerosis group were higher than those in the non-sclerosis group,while the level of 25(OH)D3 was lower than that in the non-sclerosis group(P＜0.05).Multivariate logistic regression analysis showed that serum Hcy,Lp(a)and 25(OH)D3 were risk factors of carotid atherosclerosis in T2DM patients with hypertension(P＜0.05).Pearson correlation analysis showed that Hcy and Lp(a)were positively correlated with IMT(r=0.502,0.557,P＜0.05),while 25(OH)D3 was negatively correlated with IMT(r=-0.535,P＜0.05).ROC analysis revealed that the areas under curves of serum Hcy,Lp(a)and 25(OH)D3 levels on predicting efficiency of carotid atherosclerosis were 0.704,0.738 and 0.714,respectively.Conclusion T2DM patients with hypertension have a high risk of carotid atherosclerosis.High serum Hcy and Lp(a)and low serum 25(OH)D3 are independent risk factors of carotid atherosclerosis in patients with T2DM and hypertension,and they have good an efficiency on predicting the occurrence of carotid atherosclerosis.It is necessary to strengthen the clinical monitoring of levels of serum Hcy,Lp(a)and 25(OH)D3 in T2DM patients with hypertension timely to prevent and treat carotid atherosclerosis.
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