Relationship between serum level of Apelin, Ang II and carotid intima-media thickness in patients with type 2 diabetes mellitus

Objective To explore the relationship between serum level of Apelin, angiotensin (Ang)Ⅱ and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus(T2DM). Methods A total of 103 patients with T2DM admitted to the First Affiliated Hospital of Bengbu Medical College from January 2018 to June 2018 were selected. All patients were divided into two groups based on CIMT: CIMT 0.9 mm (ACIMT group, n=55). In addition, 49 healthy subjects underwent physical examination during the same time were selected as the normal control group (NC group, n=49). Body mass index (BMI) and waist-hip ratio (WHR) were calculated; systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded; fasting glucose (FPG), HbA1c, total cholesterol (TC) and triglyceride (TG) were measured for all the selected individuals. Meanwhile, enzyme-like immunosorbent assay was used to determine fasting serum Apelin and Ang Ⅱ levels. Differences of these indicators were compared among the three groups. The related factors of Apelin and Ang Ⅱ were analyzed by Pearson correlation analysis, and the influential factors of CIMT were analyzed by logistic binary regression. Results Compared with NC group, serum level of Apelin in NCIMT group was increased; compared with ACIMT group, serum level of Apelin in NCIMT group was decreased (F=17.768, P<0.01). Compared with NC group, serum level of Ang Ⅱ was increased in NCIMT group, and compared with NCIMT group, serum level of Ang Ⅱ was increased in ACIMT group(F=8.727, P<0.01). Pearson correlation analysis showed that serum level of Apelin was positively correlated with waist circumference, WHR, TC, FPG and HbA1c (r=0.223, 0.238, 0.271, 0.227, 0.580, respectively, all P<0. 05). Serum level of Ang Ⅱ was positively correlated with SBP, HbA1c and TC (r=0.190, 0.459, 0.267, all P<0.05). Logistic binary regression analysis showed that age, HbA1c and Ang Ⅱ were positively correlated with CIMT(OR=1.087, 95%CI: 1.033-1.145, P=0.001; OR=1.986, 95%CI: 1.189-3.316, P=0.009; OR=1.021, 95%CI: 1.009-1.033, P=0.000), while Apelin was negatively correlated to CIMT(OR=0.098, 95%CI: 0.997-0.999, P=0.004). Conclusion Serum Apelin is a protective factor for CIMT, and Ang Ⅱ is a risk factor for CIMT and may be associated with the development of atherosclerosis in patients with T2DM. Key words: Type 2 diabetes mellitus; Apelin; Carotid intima-media thickness; Angiotensin Ⅱ