Objective To evaluate the correlations of growth arrest specific 6 (GAS6) and C1q/TNF-related protein 4 (CTRP4) levels with carotid atherosclerosis (CAS) in patients with type 2 diabetes (T2DM).
Methods A total of 60 T2DM patients with CAS confirmed by ultrasound were retrospectively selected as T2DM+CAS group, and 60 T2DM patients without CAS confirmed by ultrasound were selected as T2DM group according to a matching ratio of 1 to 1 in gender as well as addition and subtraction of age for 2 years. A questionnaire was developed to collect clinical data of the patients. Plasma GAS6 and serum CTRP4 levels were measured by enzyme-linked immunosorbent assay (ELISA). Logistic regression analysis was used to evaluate the risk factors of CAS in T2DM patients. The receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated to evaluate the predictive efficacy of plasma GAS6 level and serum CTRP4 level for CAS in T2DM patients.
Results There were no significant differences in age, body mass index, waist circumference, smoking, blood pressure and levels of relevant biochemical indicators between the two groups (P>0.05). The prevalence of hypertension in the T2DM+CAS group was higher than that in the T2DM group, and the levels of GAS6 and CTRP4 were lower than those in the T2DM group, and the differences were statistically significant (P < 0.05). Logistic regression analysis showed that increase of every 1 ng/mL in GAS6 and CTRP4 levels respectively leaded to 0.508 times (OR=0.508, 95%CI, 0.345 to 0.747, P=0.001) and 0.883 times of decrease in the risk of CAS in T2DM patients (OR=0.883, 95%CI, 0.819 to 0.952, P=0.001). Hypertension increased the risk of CAS in T2DM patients by 3.051 times (OR=3.051, 95%CI, 1.438 to 6.473, P=0.004). The maximum Youden index of GAS6 or CTRP4 alone and their combination in predicting CAS in T2DM patients was 0.417, 0.384 and 0.517, respectively, with the corresponding sensitivity of 85.0%, 81.7% and 81.7%, and the specificity of 58.3%, 56.7% and 70.0%, respectively.
Conclusion Plasma GAS6 and CTRP4 levels are negatively correlated with the risk of CAS in T2DM patients, and the combination of plasma GAS6 and CTRP4 has a good predictive value for CAS in T2DM patients.
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