A study on the correlation between carotid artery lesions and blood lipids, pulse pressure, and brachial-ankle index in patients with newly diagnosed type 2 diabetes mellitus

doi:10.3877/cma.j.issn.2095-9605.2025.04.004

Abstract

Abstract:

Objective

To explore the relationship between carotid artery abnormalities and blood lipids, pulse pressure index (PPI), and ankle-brachial index (ABI) in newly diagnosed type 2 diabetes mellitus (T2DM) patients.

Methods

A total of 219 newly diagnosed T2DM patients from the Department of Endocrinology of the First Affiliated Hospital of Jinan University from January to December 2023 were selected for carotid artery ultrasound examination, blood sample testing, and other examinations. The correlation between carotid artery lesions and blood lipids, pulse pressure, and ankle-brachial index in newly diagnosed T2DM patients was analyzed.

Results

The age, SBP, PP, PPI, Cys C, HDL-C, and the prevalence of hypertension in the carotid artery abnormal group were significantly higher than those in the carotid artery normal group (P<0.05), while the TG level was lower than that in the carotid artery normal group (P<0.05). Spearman correlation analysis showed that the carotid intima-media thickness (CIMT) in newly diagnosed T2DM patients was positively correlated with age, PPI, HDL-C, onset type, and history of hypertension (P<0.05). Logistic regression analysis showed that HDL-C was an influencing factor for carotid plaque formation in newly diagnosed T2DM patients.

Conclusions

Reduced HDL-C levels are a risk factor for carotid artery lesions in newly diagnosed T2DM patients. Therefore, initiating management of lipid indicators as early as possible is particularly important for this patient population. Young patients, in particular, require stricter monitoring and regulation of their lipid levels.

Key words: Newly diagnosed type 2 diabetes mellitus, Carotid artery disease, Blood lipid, Pulse pressure index, Brachial-ankle index

Xiaoling Lin, Tianning Liu, Xingxing Ai, Jiewei Huang, Xianghua Yuan, Wane Zhao, Xueyan Liu. A study on the correlation between carotid artery lesions and blood lipids, pulse pressure, and brachial-ankle index in patients with newly diagnosed type 2 diabetes mellitus[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2025, 11(04): 276-281.

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References 35

[1]	中华医学会内分泌学分会, 中国成人2型糖尿病降压治疗目标研究工作组. 2型糖尿病早期大血管病变无创性检查的中国专家共识 [J]. 中华内分泌代谢杂志, 2022, 38(6): 465-474.
[2]	汪国栋, 孙月秋, 王锦梅, 等. 大动脉僵硬度与高血压人群新发糖尿病的关系 [J]. 中华高血压杂志, 2020, 28(2): 144-148.
[3]	Sharif S, Visseren FLJ, Spiering W, et al. Arterial stiffness as a risk factor for cardiovascular events and all-cause mortality in people with Type 2 diabetes [J]. Diabet. Med. J. Br. Diabet. Assoc., 2019, 36(9): 1125-1132.
[4]	尚依一, 刘罗, 张艳, 等. 脉压和脉压指数与糖尿病心肌病患者心脏结构和功能的相关性研究 [J]. 昆明理工大学学报(自然科学版), 2021, 46(2): 82-87.
[5]	李尉键, 方伟, 蔡泽锋, 等. 高血压人群脉压与新发糖尿病的关系探讨 [J]. 中华心血管病杂志, 2021, 49(7): 673-679.
[6]	潘振宇, 李莉华, 柳和春, 等. 2型糖尿病患者颈动脉病变与血脂、臂踝脉波传速、踝肱指数的关系 [J]. 营养学报, 2021, 43(1): 49-53.
[7]	中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版) [J].中华内分泌代谢杂志, 2021, 37(4): 311-398.
[8]	中国医师协会超声医师分会,何文,勇强.超声评价颈动脉易损斑块中国专家共识(2023版) [J]. 中华超声影像学志, 2023, 32(8): 645-655.
[9]	王祎洁, 徐汉文, 张文琼, 等. 新诊断2型糖尿病患者亚临床颈动脉粥样硬化的影响因素及综合治疗后的转归情况 [J]. 南京医科大学学报(自然科学版), 2024, 44(7): 927-933.
[10]	刘浩, 董智慧, 符伟国. 糖尿病下肢动脉疾病的诊治进展 [J]. 中华糖尿病杂志, 2024, 16(1): 43-47.
[11]	Karadavut S, Kelesoglu S, Elcik D. relationship between the progression of coronary artery disease and pulse pressure index: a cross-sectional work [J]. Angiology, 2023, 74(7): 687-692.
[12]	Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition [J]. Diabetes Res Clin Pract, 2019, 157: 107843.
[13]	田慧, 李春霖, 纪立农. 中国老年2型糖尿病防治临床指南(2022年版) [J].中国糖尿病杂志, 2022, 30(1): 2-51.
[14]	钟姣. 2型糖尿病患者HbA1c、血脂水平与颈动脉内膜中层厚度的相关性研究 [J]. 中外医学研究, 2017, 15(30): 10-11.
[15]	李美. 2型糖尿病患者IGF-1、血脂水平与颈动脉内膜中层厚度的相关性研究 [J]. 实用糖尿病杂志, 2018, 14(5): 38-39.
[16]	张成洲, 陈健, 孟民, 等. 血红蛋白糖化指数与2型糖尿病患者颈动脉内膜中层厚度的相关性研究 [J]. 南京医科大学学报(自然科学版), 2025, 45(3): 367-372.
[17]	社区成人血脂管理中国专家共识撰写组. 社区成人血脂管理中国专家共识(2024年)[J]. 中华全科医师杂志, 2024, 23(3): 220-228.
[18]	Sattar N, Rawshani A, Franzén S, et al. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks [J]. Circulation, 2019, 139(19): 2228-2237.
[19]	袁慧娟, 杨俊朋, 邓欣如, 等. 成人早发2型糖尿病诊治专家共识 [J]. 中华实用诊断与治疗杂志, 2022, 36(12): 1189-1198.
[20]	Magliano DJ, Sacre JW, Harding JL, et al. Young-onset type 2 diabetes mellitus - implications for morbidity and mortality [J]. Nat. Rev. Endocrinol., 2020, 16(6): 321-331.
[21]	刘杰, 顾天伟, 钟胜利, 等. 住院早发2型糖尿病患者代谢特征及慢性并发症情况 [J]. 中华糖尿病杂志, 2020, 12(6): 387-392.
[22]	董文静, 庞萍, 宋凌云, 等. 中国成人血浆糖化血红蛋白/高密度脂蛋白比值与尿白蛋白/肌酐比值的关系 [J]. 中华内科杂志, 2024, 63(12): 1228-1237.
[23]	Xepapadaki E, Nikdima I, Sagiadinou EC, et al. HDL and type 2 diabetes: the chicken or the egg? [J]. Diabetologia, 2021, 64(9): 1917-1926.
[24]	Madsen CM, Varbo A, Nordestgaard BG. Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: two prospective cohort studies [J]. Eur Heart J, 2017, 38(32): 2478-2486.
[25]	杨亚柳, 陈红, 孙艺红. 高密度脂蛋白胆固醇:"好"胆固醇? [J]. 中华心血管病杂志, 2023, 51(7): 693-695.
[26]	Yu JX, Wu SL, Chen SH, et al. [Association between high-density lipoprotein cholesterol level and cardiovascular disease and all-cause mortality in the elderly population] [J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2022, 50(8): 791-798.
[27]	Zanoni P, Khetarpal SA, Larach DB, et al. Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease [J]. Science, 2016, 351(6278): 1166-1171.
[28]	尹丹妮, 王玲玲, 张进, 等. 糖尿病与颈动脉斑块炎症相关性的动态对比增强磁共振成像研究 [J]. 临床放射学杂志, 2025, 44(2): 237-242.
[29]	Monteiro CI, Simões RP, Goulart CL, et al. Arterial stiffness in type 2 diabetes: determinants and indication of a discriminative value [J]. Clin. Sao Paulo Braz, 2021, 76: e2172.
[30]	王文竹, 李树立. 高血压患者颈动脉内膜中层厚度与动态脉压和动态脉压指数的关系 [J]. 中华高血压杂志, 2013, 21(8): 775-777..
[31]	Gerhard-Herman M D, Gornik H L, Barrett C, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the american college of cardiology/american heart association task force on clinical practice guidelines [J]. Circulation, 2018, 137: e726-e779.
[32]	王健. 踝肱指数与趾肱指数对2型糖尿病下肢周围动脉疾病的早期诊断价值 [J]. 中国医刊, 2020, 55(7): 723-726.
[33]	林丽丽, 陈林江, 王涵菁, 等. 踝肱指数评估2型糖尿病微血管并发症的临床价值 [J]. 实用医学杂志, 2019, 35(18): 2857-2861.
[34]	Da Cruz GB, Ribeiro CTD, De Oliveira CM, et al. Prevalence of peripheral arterial disease and its association with claudication in individuals with type 2 Diabetes Mellitus: a prospective cross-sectional study in Brazil [J]. J Vasc Bras, 2025, 24: e20240085.
[35]	Alyahyaee AA, Mahmoud E, AlAzeezi AA, et al. Prevalence and risk factors of peripheral artery disease in diabetic patients: insights from a retrospective cross-sectional and cohort study in abu dhabi [J]. Vasc. Health Risk Manag., 2025, 21: 167-180.

变量	颈动脉正常组（n=77）	颈动脉异常组（n=142）	χ²（t）值	P值
性别（男/女）	58/19	89/53	3.62^a	0.057
年龄（<60岁/≥60岁）	74/3	90/52	25.90^a	<0.001
BMI（kg/m²）	26.01±4.39	25.28±4.25	1.16	0.245
SBP（mmHg）	125.79±15.21	132.66±17.87	-2.86	0.005
DBP（mmHg）	80.35±11.13	80.49±11.43	-0.08	0.929
PP	45.44±10.16	52.09±14.50	203.02	<0.001
PPI	0.36±0.06	0.38±0.07	217	0.005
高血压（%）	17（22.1%）	65（45.8%）	11.96^a	0.001
高脂血症（%）	24（31.2%）	38（26.8%）	0.478^a	0.489

变量	颈动脉正常组（n=77）	颈动脉异常组（n=142）	χ²（t）值	P值
性别（男/女）	58/19	89/53	3.62^a	0.057
年龄（<60岁/≥60岁）	74/3	90/52	25.90^a	<0.001
BMI（kg/m²）	26.01±4.39	25.28±4.25	1.16	0.245
SBP（mmHg）	125.79±15.21	132.66±17.87	-2.86	0.005
DBP（mmHg）	80.35±11.13	80.49±11.43	-0.08	0.929
PP	45.44±10.16	52.09±14.50	203.02	<0.001
PPI	0.36±0.06	0.38±0.07	217	0.005
高血压（%）	17（22.1%）	65（45.8%）	11.96^a	0.001
高脂血症（%）	24（31.2%）	38（26.8%）	0.478^a	0.489

变量	颈动脉正常组（n=77）	颈动脉异常组（n=142）	χ²（Z/t）值	P值
GLU（mmol/L）	10.46±4.36	10.05±4.93	0.609	0.543
HbA1c（±s，%）	10.94±2.77	10.74±2.89	0.486	0.672
Cys C（mg/L）	0.82(0.73,0.92)	0.90（0.75,1.13）	-2.389^a	0.017
UA（umol/L）	398.87±146.08	365.99±113.29	1.848	0.66
SCR（umol/L)	66.30（57.50, 73.90）	65.00（54.42,81.70）	-0.510^a	0.610
LDL-C（mmol/L）	3.28±0.96	3.41±1.09	0.609	0.543
TG（mmol/L）	2.39±2.36	1.78±1.13	2.118	0.037
HDL-C（mmol/L）	1.10±0.29	1.23±0.53	-2.049	0.042
TC（mmol/L）	5.46（4.48,6.04）	5.61（4.47,6.60）	-1.226^a	0.205
ABI（%）	7（9.1%）	22（15.5%）	1.781^b	0.182

变量	颈动脉正常组（n=77）	颈动脉异常组（n=142）	χ²（Z/t）值	P值
GLU（mmol/L）	10.46±4.36	10.05±4.93	0.609	0.543
HbA1c（±s，%）	10.94±2.77	10.74±2.89	0.486	0.672
Cys C（mg/L）	0.82(0.73,0.92)	0.90（0.75,1.13）	-2.389^a	0.017
UA（umol/L）	398.87±146.08	365.99±113.29	1.848	0.66
SCR（umol/L)	66.30（57.50, 73.90）	65.00（54.42,81.70）	-0.510^a	0.610
LDL-C（mmol/L）	3.28±0.96	3.41±1.09	0.609	0.543
TG（mmol/L）	2.39±2.36	1.78±1.13	2.118	0.037
HDL-C（mmol/L）	1.10±0.29	1.23±0.53	-2.049	0.042
TC（mmol/L）	5.46（4.48,6.04）	5.61（4.47,6.60）	-1.226^a	0.205
ABI（%）	7（9.1%）	22（15.5%）	1.781^b	0.182

变量	CIMT
变量	r	P值
年龄	0.344	<0.001
PPI	0.209	0.002
TG	-0.086	0.206
HDL-C	0.166	0.014
ABI	0.090	0.184
高血压病史	0.227	0.001

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