2型糖尿病患者血清胰岛素样生长因子-1水平与颈动脉不稳定性斑块的相关性

The Correlation Between Serum Insulin-like Growth Factor-1 Levels and Carotid Unstable Plaques in Patients with Type 2 Diabetes Mellitus

目的:分析2型糖尿病患者血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平与颈动脉不稳定性斑块的相关性。方法:选取孝感市中心医院内分泌科2022年2月至2023年2月住院治疗的2型糖尿病患者213例,使用彩色多普勒超声诊断仪测定双侧颈总动脉、分叉及颈内动脉、颈外动脉的内壁,根据超声影像特征将研究对象分为无斑块组(73例)、稳定性斑块组(51例)、不稳定性斑块组(89例)。检测并比较各组临床资料、实验室指标及血清IGF-1水平;采用Spearman相关分析探讨2型糖尿病患者合并颈动脉不稳定斑块组血清IGF-1水平与各指标的关系;采用多因素Logistic回归分析2型糖尿病患者颈动脉斑块不稳定的影响因素。结果:与无斑块组比较,稳定性斑块组年龄、收缩压、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平较高,IGF-1水平较低;不稳定斑块组年龄、HbA1c、TG、LDL-C水平较高,IGF-1水平较低,差异均有统计学意义(P<0.05)。与稳定性斑块组比较,不稳定性斑块组HbA1c、TG、LDL-C水平较高,收缩压、IGF-1水平较低,差异有统计学意义(P<0.05)。Spearman相关分析显示,2型糖尿病合并颈动脉不稳定斑块组患者血清IGF-1水平与年龄、收缩压、HbA1c、LDL-C呈负相关(P<0.05)。Logistic回归分析显示,血清HbA1c、LDL-C、TG、IGF-1为2型糖尿病患者颈动脉斑块不稳定的影响因素(P<0.05)。结论:IGF-1低水平可能为2型糖尿病患者颈动脉斑块不稳定的影响因素,可辅助评估斑块的形成及进展。

Objective:To analyze the correlation between serum insulin-like growth factor-1(IGF-1) levels and carotid unstable plaques in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 213 T2DM patients admitted to the Department of Endocrinology at Xiaogan Central Hospital from February 2022 to February 2023 were selected.Bilateral common carotid arteries,bifurcations,and internal and external carotid arteries were examined using color Doppler ultrasound.Based on the characteristics of the ultrasound images,the subjects were divided into three groups:no plaque group(73 cases),stable plaque group(51 cases),and unstable plaque group(89 cases).Clinical data,laboratory indicators,and serum IGF-1 levels were detected and compared among the groups.Spearman correlation analysis was used to investigate the relationship between serum IGF-1 levels and various indicators in T2DM patients with carotid unstable plaques.Multivariate logistic regression analysis was used to identify the influencing factors of carotid plaque instability in T2DM patients.Results:Compared with the no plaque group,the stable plaque group had higher levels of age,systolic blood pressure,glycosylated hemoglobin(HbA1c),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C),but lower levels of IGF-1;the unstable plaque group also had higher levels of age,HbA1c,TG,and LDL-C,but lower levels of IGF-1,with statistically significant differences(P<0.05).Compared with the stable plaque group,the unstable plaque group had higher levels of HbA1c,TG,and LDL-C,but lower levels of systolic blood pressure and IGF-1,with statistically significant differences(P<0.05).Spearman correlation analysis showed that serum IGF-1 levels in T2DM patients with carotid unstable plaques were negatively correlated with age,systolic blood pressure,HbA1c,and LDL-C(P<0.05).Logistic regression analysis indicated that serum HbA1c,LDL-C,TG,and IGF-1 were influencing factors for carotid plaque instability in T2DM patients(P<0.05).Conclusion:Low levels of IGF-1 may be a contributing factor to the instability of carotid artery plaques in patients with type 2 diabetes and can aid in the assessment of plaque formation and progression.