Correlations Between Lipid Profiles and Atherosclerotic Plaque Characteristics in Patients with Type 2 Diabetes Mellitus

Lili Qiao^1*Miao Jiameng^2*Weixuan Du¹Yi Liu¹Yanrong CHen¹Kaiyue Xu¹CHen Wang³Heye CHen⁴

• ¹Affiliated Hospital of Hebei University, Baoding, China
• ²Chinese People's Liberation Army 82nd Army Group Hospital, Baoding, China
• ³Tangshan Gongren Hospital, Tangshan, China
• ⁴Jinhua Municipal Central Hospital Central Laboratory, Jinhua, China

Word count: 255 Background and Purpose:Diabetes mellitus and dyslipidemia are major risk factors for atherosclerosis. Hypoechoic plaques, which indicate vulnerable or unstable plaques, may rupture and lead to ischemic stroke, cognitive impairment, increased adverse cardiac events,and even death. This study aimed to investigate the correlation between plasma lipid levels and the characteristics of atherosclerotic plaques in adult patients with type 2 diabetes mellitus.Methods: A retrospective analysis was conducted on adult patients with type 2 mellitus who were hospitalized in the Department of Endocrinology at Affiliated Hospital of Hebei University between January 2017 and December 2021. Patients were categorized into two groups based on arterial ultrasound results. Statistical analyses were performed to compare plasma 1 Abbreviations:T2DM,type 2 diabetes mellitus;ASCVD,atherosclerotic cardiovascular diseases;CVD,cardiovascular diseases;PAD,Peripheral Artery Disease;TC,total cholesterol;TG,triglycerides;HDL,high-density lipoprotein cholesterol;LDL,low-density lipoprotein cholesterol;sdLDL,small dense low-density lipoprotein;VLDL,very-low-density lipoprotein;ApoA1,Apolipoprotein A1;ApoB,apolipoprotein B. lipid levels and plaque characteristics across the groups.Results:1)Statistically significant differences were observed among the two groups in terms of gender,hypertension,age,duration of diabetes mellitus,plaque location,triglycerides(TG),total cholesterol(TC),Apolipoprotein A1(Apo A1),very-low-density lipoprotein(VLDL),VLDL/apolipoprotein B(ApoB), high-density lipoprotein cholesterol(HDL)/ApoA1 (P<0.05).2)Univariate and multivariate regression analyses revealed that VLDL, VLDL/ApoB and HDL/ApoA1 were correlated with plaque stability,the higher the levels of VLDL, VLDL/ApoB and HDL/ApoA1, the more likely they were to be hypoechoic plaque group (OR>1,P<0.05).3)VLDL, VLDL/ApoB and HDL/ApoA1 showed predictive value for determining whether patients with type 2 diabetes had stable plaques.The area under the receiver operating characteristic(ROC) curve for VLDL,VLDL/ApoB and HDL/ApoA1 respectively were 0.789,0.779 and 0.728.Conclusion:In clinical practice, the characteristics of atherosclerotic plaques and lipid profiles should be jointly evaluated to guide targeted treatment and effectively reduce the risk of atherosclerotic cardiovascular disease.