Abstract:

Objective  To investigate the relationship between the carotid intima media thickness(IMT) and the expression of plasma homocysteine(Hcy), interleukin-17(IL-17), neutrophil gelatinase-associated lipocalin(NGAL) in elderly patients with type 2 diabetes mellitus(T2DM) and macrovascular disease.

Methods  In total, 92 elderly T2DM patients with macrovascular disease in our hospital were selected as the observation group, and 92 elderly T2DM patients without macrovascular disease were selected as the control group. The clinical data, carotid IMT, Hcy, IL-17 and NGAL levels were compared between two groups. The factors influencing the pathogenesis of T2DM and macrovascular disease in the elderly, the correlation between carotid IMT and Hcy, IL-17, NGAL levels, and the diagnostic value of carotid IMT, Hcy, IL-17, NGAL levels in the diagnosis of T2DM and macrovascular disease in the elderly patients were analyzed. The prognosis of patients with positive and negative disease by combined diagnosis was compared.

Results  The levels of triacylglycerol（TG）, low density lipoprotein cholesterol（LDL-C） and carotid IMT, Hcy, IL-17 and NGAL in the observation group were higher than those in the control group, and the difference was statistically significant(P＜0.05). Logistic regression analysis showed that the levels of carotid IMT, Hcy, IL-17, and NGAL were all influential factors in the pathogenesis of T2DM and macrovascular disease in the elderly patients(P＜0.05). The carotid IMT of the elderly patients with T2DM and macrovascular disease was positively correlated with Hcy, IL-17 and NGAL levels(P＜0.05). The area under ROC curve(AUC) of the elderly T2DM patients with macrovascular disease diagnosed by carotid IMT, Hcy, IL-17, and NGAL levels was the largest, which was 0.951, suggesting good diagnostic efficiency. The physical health, physical role function, physical pain and overall health scores of positive patients by combined diagnosis were lower than those of negative patients, and the difference was statistically significant(P＜0.05).

Conclusion  In elderly patients with T2DM and macrovascular disease, carotid IMT is related to the expression of plasma Hcy, IL-17, and NGAL. Each index can be used to effectively diagnose macrovascular disease, which is beneficial to clinical diagnosis and treatment.

Key words: diabetes mellitus, type 2； diabetic angiopathies, carotid intima-media thickness