Correlation of Serum CysC, IMA, and LP-PLA2 Levels With Type 2 Diabetes Mellitus Patients With Lower Extremity Atherosclerotic Occlusive Disease

Abstract

ObjectiveTo investigate the serum level of cystatin C (CysC), ischemia-modified albumin (IMA), and lipoprotein-associated phospholipase A2 (LP-PLA2) in patients with type 2 diabetes mellitus (T2DM) and with lower extremity atherosclerotic occlusive disease (LEASOD) and their correlation.MethodsFrom March 2017 to December 2019, 110 patients with T2DM with LEASOD, who were treated in our hospital, were selected as the observation group. One hundred ten healthy persons who received medical examination in our hospital during the same period were selected as the control group. Serum CysC, IMA, LP-PLA2, and ankle-brachial index (ABI) were detected in each group. According to the ABI index, the observation group was divided into three subgroups, namely, the mild group (n = 45), the moderate group (n = 42), and the severe group (n = 23). Pearson correlation analysis was used to analyze the relationship between serum CysC, IMA, and LP-PLA2 levels in patients with T2DM with LEASOD and their condition. The receiver operator characteristic (ROC) curve was used to analyze the diagnostic value of serum CysC, IMA, and LP-PLA2 levels in patients with T2DM with LEASOD.ResultsThe serum levels of CysC, IMA, and LP-PLA2 in the observation group were higher than those in the control group (p < 0.05). The serum levels of CysC, IMA, and LP-PLA2 in the severe and the moderate group were higher than those in the mild group, and the serum levels of CysC, IMA, and LP-PLA2 in the severe group were higher than those in the moderate group (p < 0.05). Pearson correlation analysis showed that CysC, IMA, and LP-PLA2 levels were all negatively correlated with ABI (r = −0.802, r = −0.757, r = −0.764, p < 0.001). The ROC curve results showed that the area under the curve (AUC) of serum CysC in the diagnosis of T2DM with LEASOD was 0.806, and the best cut-off value was 1.74 mg/L. The AUC of serum IMA for diagnosis of T2DM with LEASOD was 0.772, and the best cut-off value was 92.58 g/L. The AUC of serum LP-PLA2 in the diagnosis of T2DM with LEASOD was 0.781, and the best cut-off value was 544.86 ng/L. The AUC of the three combined diagnoses of T2DM with LEASOD was 0.863.ConclusionSerum levels of CysC, IMA, and LP-PLA2 were increased in patients with T2DM with LEASOD. Serum CysC, IMA, and LP-PLA2 are closely related to the severity of the disease. The higher the serum levels of CysC, IMA, and LP-PLA2, the more serious the degree of lower extremity arteriosclerosis occlusion, which can be used as an important serum marker to monitor the severity of T2DM with LEASOD. The combined detection of serum CysC, IMA, and LP-PLA2 has good diagnostic value for patients with T2DM with LEASOD.

Transcriptomic Analysis of Type 2 Diabetes Mellitus Combined with Lower Extremity Atherosclerotic Occlusive Disease

“…The inclusion criteria were as follows: Patients met the diagnostic guidelines for T2DM and lower extremity arteriosclerosis obliterans; Patients had a medical history of T2DM with symptoms such as limb pain, intermittent claudication or ischemic ulcer, and gangrene in the lower limbs, and LEASOD was confirmed through color Doppler ultrasound, CT angiography, and other imageological tests to detect the corresponding artery stenosis or occlusion, and all patients should have complete clinical data. 6 The exclusion criteria were included patients who had acute complications of T2DM, patients with hemorrhagic diseases or disorders of the coagulation system, patients with cerebrovascular diseases, patients with severe cardiopulmonary liver and kidney failure, patients with infectious or autoimmune diseases, fever or infection, current smokers, vaccination within 3 months, history of prior organ transplantation, steroid use, estrogen replacement, AIDS, on chronic anti-inflammatory use, chemotherapy within the prior year, acquired Immune Deficiency Syndrome or immunocompromised, hemochromatosis, diagnosed with cancers, or neurodegenerative disease. 6 The average age of these patients was 50.25 ± 6.16, with the majority being between 45 and 55 years old (age ranged from 41 to 59).…”

“… 6 The exclusion criteria were included patients who had acute complications of T2DM, patients with hemorrhagic diseases or disorders of the coagulation system, patients with cerebrovascular diseases, patients with severe cardiopulmonary liver and kidney failure, patients with infectious or autoimmune diseases, fever or infection, current smokers, vaccination within 3 months, history of prior organ transplantation, steroid use, estrogen replacement, AIDS, on chronic anti-inflammatory use, chemotherapy within the prior year, acquired Immune Deficiency Syndrome or immunocompromised, hemochromatosis, diagnosed with cancers, or neurodegenerative disease. 6 The average age of these patients was 50.25 ± 6.16, with the majority being between 45 and 55 years old (age ranged from 41 to 59). Demographic data and medication of the study population are summarized in Table 1 .…”

“…T2DM can cause microvascular and peripheral vascular lesions, leading to lower extremity atherosclerotic occlusive disease (LEASOD), limb ischemia and intermittent claudication, and even lower extremity ulcer, gangrene, or amputation in severe cases. 6 LEASOD is one of the most common peripheral arteriosclerosis occlusive diseases in current society, and it is an important part of systemic arteriosclerosis disease. Its pathological changes are a group of chronic ischemic diseases that cause arterial stenosis or occlusion, such as thickening of arterial intima, calcification, and secondary thrombosis.…”

Higher serum Lp-PLA2 is associated with cognitive impairment in Parkinson’s disease patients

“…Another study found that Lp-PLA2 levels were elevated in individuals with type 2 diabetes and that Lp-PLA2 levels were higher in diabetic individuals with cognitive impairment compared to those without cognitive impairment ( Cai et al, 2017 ). Studies have reported the role of Lp-PLA2 in cognitive impairment-related diseases such as Alzheimer’s disease and diabetes ( Davidson et al, 2012 ; Feng et al, 2022 ). These results have shown elevated plasma levels of Lp-PLA2 in patients with these diseases, which are strongly associated with cognitive decline.…”