| Objective To investigate the relationship between serum matrix metalloproteinase-2/tissue inhibitor of metalloproteinase-2(MMP-2/TIMP2) ratio and concurrent aortic sclerosis(AS) in elderly patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 180 elderly patients with newly diagnosed T2DM admitted to Wanning People's Hospital from January 2022 to April 2023 were analyzed retrospectively, and the patients were divided into AS group(n=69) and non-AS group(n=111) according to whether complicated with AS [carotid femoral pulse wave velocity(cfPWV)>10 m/s]. And by means of propensity score matching, other 90 healthy people undergoing physical examination in the hospital during the same period were assigned simultaneously to the control group. The general information, laboratory indicators, and serum MMP2, TIMP2 levels, and MMP2/TIMP2 ratio of subjects in the three groups were compared. Spearman correlation analysis was used to explore the correlation of cfPWV with various indicators in elderly patients with T2DM. Multivariate logistic regression model was used to analyze the influencing factors of concurrent AS in elderly patients with T2DM. Receiver operating characteristic(ROC) curve was drawn to analyze and compare the diagnostic value of MMP2/TIMP2 ratio and multi-index combined detection for concurrent AS in elderly patients with T2DM.Results The homeostasis model insulin resistance index(HOMA-IR), serum triglyceride(TG), MMP2 levels, and MMP2/TIMP2 ratio in the non-AS group were higher than those in the control group, while serum TIMP2 level was lower than that in the control group(P<0.05). The age, proportion of hypertension in the AS group were higher than those in the non-AS group(P<0.05). The HOMA-IR, TG, MMP2 levels, and MMP2/TIMP2 ratio in the AS group were higher than those in the control group or non-AS group, while serum TIMP2 level was lower than that in the control group or non-AS group(P<0.05). The correlation analysis results showed that the cfPWV of patients in the non-AS group was positively correlated with HOMA-IR, TC, LDL-C, MMP2 and MMP2/TIMP2 ratio(r=0.217, 0.264, 0.216, 0.197, 0.703, P<0.05), and negatively correlated with TIMP2(r=-0.524, P<0.01). The cfPWV of patients in the AS group was positively correlated with MMP2and MMP2/TIMP2 ratio(r=0.659, 0.857, P<0.01), and negatively correlated with TIMP2(r=-0.532, P<0.01). Logistic regression analysis showed that ageing(OR=1.108, 95%CI:1.022~1.201, P=0.012), hypertension(OR=2.877, 95%CI:1.174~7.051, P=0.021), and elevated value of MMP2/TIMP2 ratio(OR=5.147, 95%CI:2.392~11.074, P<0.001) were independent risk factors for concurrent AS in elderly patients with T2DM. The ROC analysis results showed that the area under the curve of MMP2/TIMP2 ratio and multi-index combined detection for diagnosing concurrent AS in elderly patients with T2DM were 0.850(95%CI:0.789~0.899, P<0.01) and 0.886(95%CI:0.831~0.929, P<0.01), respectively, the sensitivity was 73.91% and 82.61%, respectively, the specificity was 89.19% and 82.88%, respectively, and the Youden index was 0.631 and 0.655, respectively. The diagnostic efficiency of multi-index combined detection was significantly higher than that of MMP2/TIMP2 ratio, and the difference was statistically significant(Z=2.233, P=0.026). The optimal cut-off value of MMP2/TIMP2 ratio for diagnosing concurrent AS in elderly patients with T2DM was 3.23.Conclusion The elevated value of MMP2/TIMP2 ratio is an independent risk factor for concurrent AS in elderly patients with T2DM, which has auxiliary value for diagnosing concurrent AS in elderly patients with T2DM, and multiindex combined detection can improve the diagnostic efficiency. |
