Chen Jia Wei, Li Chang, Liu Zhu Hui, Shen Ying, Ding Feng Hua, Shu Xin Yi, Zhang Rui Yan, Shen Wei Feng, Lu Lin, Wang Xiao Qun
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2019 Apr 4;10:191. doi: 10.3389/fendo.2019.00191. eCollection 2019.
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. 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. In study 1, MHR was higher in patients with T2DM than non-diabetic subjects ( < 0.001). After adjustment for confounding risk factors, MHR remained correlated significantly with CIMT in diabetic ( = 0.172, = 0.001) but not non-diabetic ( = 0.006, = 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 ( = 0.313, = 0.001). Basal MHR was independently associated with change in CIMT [β = 0.059, (95% CI: 0.012-0.105), = 0.014] in multivariate linear regression analysis. 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.
2型糖尿病（T2DM）中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生的重要因素。单核细胞与高密度脂蛋白胆固醇（HDL-C）的比值（MHR）是一种新的简单指标，与机体炎症和氧化应激状态呈正相关。然而，关于MHR在评估颈动脉内膜中层厚度（CIMT）（后续血管事件的替代预测指标）中的作用，人们了解甚少，尤其是在糖尿病患者中。研究1连续纳入了494例T2DM患者和1848例非糖尿病受试者。比较了糖尿病和非糖尿病受试者中MHR与CIMT的相关性。在研究2中，从研究1中纳入了110例基础CIMT正常且在12个月时进行了随访超声检查的T2DM患者。分析了MHR对糖尿病患者CIMT进展的影响。在研究1中，T2DM患者的MHR高于非糖尿病受试者（<0.001）。在调整混杂危险因素后，MHR在糖尿病受试者中仍与CIMT显著相关（=0.172，=0.001），而在非糖尿病受试者中则无显著相关性（=0.006，=0.813）。逻辑回归分析表明，在糖尿病患者中，MHR在与CIMT升高的相关性方面优于传统血脂参数。在研究2中，基线时的MHR与CIMT的变化呈正相关（=0.313，=0.001）。在多变量线性回归分析中，基础MHR与CIMT的变化独立相关[β=0.059，（95%CI：0.012-0.105），=0.014]。我们的研究表明，MHR是预测T2DM患者亚临床颈动脉粥样硬化的存在和进展的一种便捷有效的指标。
