Comprehensive analysis of risk factors associated with carotid plaque in patients with type 2 diabetes mellitus.

IF 4.6 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-08-15 DOI:10.4239/wjd.v16.i8.104180

Lei Shi, Neng-Juan Li

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Abstract

Background: Carotid atherosclerosis is a common complication in patients with type 2 diabetes mellitus (T2DM) and is closely associated with an increased risk of cardiovascular events.

Aim: To identify the key demographic, clinical, and biochemical factors associated with carotid plaque formation in T2DM patients and evaluate their predictive value.

Methods: This retrospective study included 266 T2DM patients (control group, n = 158; observation group, n = 108) recruited between January 2021 and July 2024. Participants underwent carotid ultrasonography to measure intima-media thickness (IMT) and detect carotid plaques. Comprehensive demographic and biochemical data, including age, body mass index (BMI), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), serum creatinine (Scr), urinary albumin-to-creatinine ratio (UACR), and serum uric acid (SUA), were collected. Statistical analyses, including Pearson correlation, logistic regression, and receiver operating characteristic (ROC) curve analysis, were performed to identify and evaluate factors associated with carotid plaque formation.

Results: Significant differences in age, BMI, HbA1c, FPG, Scr, UACR, and SUA were observed between groups (all P < 0.05). Pearson correlation analysis showed IMT was positively associated with age, FPG, HbA1c, Scr, UACR, and SUA, and negatively with HDL-C. Multivariate logistic regression identified age (OR = 1.050, 95%CI: 1.015-1.087), FPG (OR = 1.096, 95%CI: 1.006-1.192), HbA1c (OR = 1.234, 95%CI: 1.057-1.445), SBP (OR = 1.018, 95%CI: 1.002-1.034), Scr (OR = 1.029, 95%CI: 1.011-1.046), UACR (OR = 1.024, 95%CI: 1.010-1.037), SUA (OR = 1.006, 95%CI: 1.003-1.009), and HDL-C (OR = 0.329, 95%CI: 0.119-0.917) as independent predictors of IMT (all P < 0.05). ROC analysis showed UACR (AUC = 0.718) and SUA (AUC = 0.651) had predictive value for carotid plaque.

Conclusion: This study highlights the multifactorial nature of carotid atherosclerosis in T2DM, with age, BMI, poor glycemic control, renal dysfunction, and metabolic disturbances identified as key risk factors. The findings underscore the importance of comprehensive risk assessment and targeted interventions to prevent vascular complications in this high-risk population.

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2型糖尿病患者颈动脉斑块相关危险因素的综合分析

背景：颈动脉粥样硬化是2型糖尿病（T2DM）患者的常见并发症，与心血管事件风险增加密切相关。目的：探讨与T2DM患者颈动脉斑块形成相关的关键人口学、临床和生化因素，并评价其预测价值。方法：回顾性研究纳入2021年1月至2024年7月招募的266例T2DM患者（对照组158例，观察组108例）。参与者接受颈动脉超声检查以测量内膜-中膜厚度（IMT）并检测颈动脉斑块。收集年龄、体重指数（BMI）、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、血清肌酐（Scr）、尿白蛋白/肌酐比（UACR）、血清尿酸（SUA）等综合人口学和生化数据。统计分析包括Pearson相关、logistic回归和受试者工作特征（ROC）曲线分析，以确定和评估与颈动脉斑块形成相关的因素。结果：组间年龄、BMI、HbA1c、FPG、Scr、UACR、SUA差异均有统计学意义（均P < 0.05）。Pearson相关分析显示，IMT与年龄、FPG、HbA1c、Scr、UACR、SUA呈正相关，与HDL-C呈负相关。多因素logistic回归确定年龄（OR = 1.050, 95%CI: 1.015 ~ 1.087）、FPG （OR = 1.096, 95%CI: 1.006 ~ 1.192）、糖化血红蛋白（OR = 1.234, 95%CI: 1.057 ~ 1.445）、sba1c （OR = 1.018, 95%CI: 1.002 ~ 1.034）、Scr （OR = 1.029, 95%CI: 1.011 ~ 1.046）、UACR （OR = 1.024, 95%CI: 1.010 ~ 1.037）、SUA （OR = 1.006, 95%CI: 1.003 ~ 1.009）、HDL-C （OR = 0.329, 95%CI: 0.119 ~ 0.917）为IMT的独立预测因子（均P < 0.05）。ROC分析显示UACR （AUC = 0.718）和SUA （AUC = 0.651）对颈动脉斑块具有预测价值。结论：本研究强调T2DM患者颈动脉粥样硬化的多因素性，年龄、BMI、血糖控制不良、肾功能不全和代谢紊乱是关键危险因素。研究结果强调了在这一高危人群中进行全面风险评估和有针对性干预以预防血管并发症的重要性。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.