Association of serum PECAM-1 and Sirt1 levels with carotid atherosclerosis in type 2 diabetic patients

doi:10.3877/cma.j.issn.1674-0785.2023.03.010

Abstract

Abstract:

Objective

To investigate the relationship between serum platelet endothelial cell adhesion molecule 1 (PECAM-1) and silent information regulator factor 2-related enzyme 1 (Sirt1) levels and carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 165 patients with T2DM admitted to our hospital from January 2021 to February 2022 (T2DM group) were selected and divided into either a CAS group (48 cases) or a non-CAS group (117 cases) according to the carotid intima-media thickness (CIMT), and 61 healthy individuals who underwent physical examination ring the same period were selected as a control group. Serum PECAM-1 and Sirt1 levels were measured by enzyme-linked immunosorbent assay and compared between the T2DM group and the control group. Multi-factor logistic regression was used to identify the factors influencing CAS in T2DM patients. The clinical value of serum PECAM-1 and Sirt1 levels in predicting CAS in T2DM patients was assessed by receiver operating characteristic (ROC) curve analysis.

Results

Compared with the control group, serum PECAM-1 level was higher and Sirt1 level was lower in the T2DM group (P＜0.05). Serum PECAM-1 levels were positively correlated with CIMT and Sirt1 levels were negatively correlated with CIMT in T2DM patients (r_s=0.789 and -0.785, respectively; P＜0.001 for both). The duration of T2DM (odds ratio [OR]=1.483, 95% confidence interval [CI]: 1.090~2.017), smoking (OR=1.408, 95% CI: 1.054~1.881), glycated hemoglobin A1c (HbA1c) (OR=2.900, 95% CI: 1.324~6.350), low-density lipoprotein cholesterol (LDL-C) (OR=1.474, 95% CI: 1.182~1.838), and PECAM-1 (OR=1.540, 95% CI: 1.191~1.990) were independent risk factors for CAS in patients with T2DM, and Sirt1 (OR=0.397, 95% CI: 0.256~0.617) was an independent protective factor (P＜0.05). The area under the curve (AUC) values of serum PECAM-1 and Sirt1 levels alone and in combination to predict CAS in T2DM patients were 0.795, 0.797, and 0.893, respectively, and the AUC of serum PECAM-1 and Sirt1 levels in combination to predict CAS in T2DM patients was greater than that of either of them alone (P＜0.05).

Conclusion

Increased serum PECAM-1 levels and decreased Sirt1 levels in T2DM patients are independent influencing factors for the occurrence of CAS and can be used as an auxiliary predictor of CAS in T2DM patients.

Key words: Type 2 diabetes mellitus, Carotid atherosclerosis, Platelet endothelial cell adhesion molecule 1, Silent information regulator factor 2-related enzyme 1

Lu Tao, Nan Chu, Jie Han, Chunying Bai, Wenli Pang, Haiyuan Yu. Association of serum PECAM-1 and Sirt1 levels with carotid atherosclerosis in type 2 diabetic patients[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(03): 291-296.

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Figures/Tables 4

因素	CAS组（n＝48）	非CAS组（n＝117）	χ²/t/Z值	P值
男/女（n/n）	31/17	65/52	1.140	0.286
年龄（岁， $x ¯$ ±s）	58.65±8.44	55.94±8.11	1.923	0.056
体质指数（kg/m²， $x ¯$ ±s）	22.55±1.95	22.44±2.01	0.334	0.739
T2DM病程［年，M（P25，P75）］	10.00（8.00，11.00）	8.00（7.00，10.00）	3.683	＜0.001
吸烟［n（％）］	21（43.75）	27（23.08）	7.052	0.008
收缩压（mmHg， $x ¯$ ±s）	119.73±14.81	119.17±15.31	0.215	0.830
舒张压（mmHg， $x ¯$ ±s）	84.46±12.49	82.57±10.60	0.984	0.326
空腹血糖［mmol/L，M（P25，P75）］	10.07（8.89，10.95）	9.28（8.14，10.30）	3.191	0.001
HbA1c［％，M（P25，P75）］	7.94（7.37，8.36）	7.50（7.10，7.83）	4.293	＜0.001
TC（mmol/L， $x ¯$ ±s）	4.46±0.69	4.31±0.89	1.074	0.285
TG（mmol/L， $x ¯$ ±s）	1.96±0.44	1.82±0.50	1.716	0.088
HDL-C（mmol/L， $x ¯$ ±s）	0.98±0.26	1.10±0.31	2.388	0.018
LDL-C（mmol/L， $x ¯$ ±s）	3.30±0.40	2.95±0.45	4.607	＜0.001
PECAM-1（mg/L， $x ¯$ ±s）	14.69±2.84	11.34±2.79	6.973	＜0.001
Sirt1（ng/ml， $x ¯$ ±s）	4.61±1.71	6.94±2.12	6.758	＜0.001

因素	CAS组（n＝48）	非CAS组（n＝117）	χ²/t/Z值	P值
男/女（n/n）	31/17	65/52	1.140	0.286
年龄（岁， $x ¯$ ±s）	58.65±8.44	55.94±8.11	1.923	0.056
体质指数（kg/m²， $x ¯$ ±s）	22.55±1.95	22.44±2.01	0.334	0.739
T2DM病程［年，M（P25，P75）］	10.00（8.00，11.00）	8.00（7.00，10.00）	3.683	＜0.001
吸烟［n（％）］	21（43.75）	27（23.08）	7.052	0.008
收缩压（mmHg， $x ¯$ ±s）	119.73±14.81	119.17±15.31	0.215	0.830
舒张压（mmHg， $x ¯$ ±s）	84.46±12.49	82.57±10.60	0.984	0.326
空腹血糖［mmol/L，M（P25，P75）］	10.07（8.89，10.95）	9.28（8.14，10.30）	3.191	0.001
HbA1c［％，M（P25，P75）］	7.94（7.37，8.36）	7.50（7.10，7.83）	4.293	＜0.001
TC（mmol/L， $x ¯$ ±s）	4.46±0.69	4.31±0.89	1.074	0.285
TG（mmol/L， $x ¯$ ±s）	1.96±0.44	1.82±0.50	1.716	0.088
HDL-C（mmol/L， $x ¯$ ±s）	0.98±0.26	1.10±0.31	2.388	0.018
LDL-C（mmol/L， $x ¯$ ±s）	3.30±0.40	2.95±0.45	4.607	＜0.001
PECAM-1（mg/L， $x ¯$ ±s）	14.69±2.84	11.34±2.79	6.973	＜0.001
Sirt1（ng/ml， $x ¯$ ±s）	4.61±1.71	6.94±2.12	6.758	＜0.001

因素	b值	SE值	Wald χ²值	P值	OR值	95％CI值
T2DM病程	0.394	0.157	6.292	0.012	1.483	1.090~2.017
吸烟	0.342	0.148	9.209	0.002	1.408	1.054~1.881
空腹血糖	0.163	0.232	0.492	0.483	1.177	0.747~1.854
HbA1c	1.065	0.400	10.291	0.001	2.900	1.324~6.350
HDL-C	-1.260	1.072	1.381	0.240	0.284	0.035~2.319
LDL-C	0.388	0.113	10.215	0.001	1.474	1.182~1.838
PECAM-1	0.432	0.131	10.864	0.001	1.540	1.191~1.990
Sirt1	-0.924	0.225	16.916	＜0.001	0.397	0.256~0.617

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