Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, Airlangga University Faculty of Medicine, Dr. Soetomo Academic Teaching Hospital, Surabaya, 60132, Indonesia.
Department of Internal Medicine, Airlangga University Faculty of Medicine, Dr. Soetomo Academic Teaching Hospital, Surabaya, 60132, Indonesia.
F1000Res. 2023 Jun 5;11:1582. doi: 10.12688/f1000research.128627.2. eCollection 2022.
Early identification of arterial stiffness in Type 2 diabetes mellitus (T2DM) patients before the manifestation of atherosclerosis would be clinically beneficial. Our study aimed to explore the correlation of lipid profiles and ratios with arterial stiffness, and construct a predictive model for arterial stiffness in T2DM patients using those parameters. One hundred and eighty-four adult T2DM patients in the diabetes outpatient clinic at the Dr. Soetomo general academic hospital were enrolled in this cross-sectional study in 2015 and 2019. Sociodemographic, glycosylated hemoglobin (HbA1c), lipid profiles, and brachial-ankle pulse wave velocity (ba-PWV) data were collected from all subjects. The subjects were divided into a group with arterial stiffness (ba-PWV > 18 m/sec) and without arterial stiffness (ba-PWV ≤ 18 m/sec). A correlation test was used to evaluate the association, and receiver operator characteristics (ROC) curves analysis were used to determine the cut-off value, sensitivity, and specificity. The risk analysis model was calculated using bivariate logistic regression analysis. The group with arterial stiffness had higher lipid profiles: total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipid ratios. A significant positive correlation was found between TC, TG, LDL-C, and all lipid ratios with ba-PWV. A negative correlation was found between HDL-C and ba-PWV. All lipid ratio parameters can be used as predictors of arterial stiffness, especially non-HDL-C with cut-off value: 150 mg/dL (sensitivity 96.8% and specificity 52.9%) and TG/HDL-C ratio with cut-off value: 4.51 (sensitivity 81.0% and specificity 74.2%). Elevated TG/HDL-C ratio and non-HDL-C displayed higher risk (OR: 12.293 and 16.312; < 0.05) of having arterial stiffness compared to other lipid ratios. Lipid profiles and lipid ratios, especially TG/HDL-C ratio and non-HDL-C, are potential biochemical markers for arterial stiffness in T2DM patients.
2 型糖尿病患者动脉僵硬度的早期识别在动脉粥样硬化表现之前具有临床意义。本研究旨在探讨血脂谱和比值与动脉僵硬度的相关性，并利用这些参数构建 2 型糖尿病患者动脉僵硬度的预测模型。
2015 年至 2019 年，我们在苏托莫综合医院糖尿病门诊招募了 184 名成年 2 型糖尿病患者进行这项横断面研究。收集了所有受试者的社会人口统计学、糖化血红蛋白（HbA1c）、血脂谱和肱踝脉搏波速度（ba-PWV）数据。将受试者分为动脉僵硬度组（ba-PWV＞18m/s）和无动脉僵硬度组（ba-PWV≤18m/s）。采用相关检验评估相关性，采用受试者工作特征（ROC）曲线分析确定截断值、灵敏度和特异性。采用二元逻辑回归分析计算风险分析模型。
总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和血脂比值。TC、TG、LDL-C 与所有血脂比值与 ba-PWV 呈显著正相关。HDL-C 与 ba-PWV 呈负相关。所有血脂比值参数均可作为动脉僵硬度的预测指标，特别是非高密度脂蛋白胆固醇（non-HDL-C）的截断值为 150mg/dL（灵敏度 96.8%，特异性 52.9%）和 TG/HDL-C 比值的截断值为 4.51（灵敏度 81.0%，特异性 74.2%）。与其他血脂比值相比，升高的 TG/HDL-C 比值和非 HDL-C 显示出更高的动脉僵硬度风险（OR：12.293 和 16.312；<0.05）。
血脂谱和血脂比值，特别是 TG/HDL-C 比值和非 HDL-C，是 2 型糖尿病患者动脉僵硬度的潜在生化标志物。
