The relationships between novel biomarkers Lp-PLA2 and CTRP-3 and MACCE in patients with type 2 diabetes mellitus aged 40-65 years in a population-based study

Background: Adverse cardiovascular and cerebrovascular events (MACCE, mainly includes: cardiovascular or cerebrovascular death, acute coronary syndrome, coronary stent implantation, and stroke) has been confirmed as one of the major and severe complications in type 2 diabetes mellitus (T2DM) patients aged 40–65 years, and it is also reported as one of the major causes of death in T2DM patients. Accordingly, the biological markers of MACCE in T2DM patients aged 40–65 years should be found urgently. Methods The retrospective cohort study comprised 979 individuals of T2DM aged 40–65 years. To be specific, 116 subjects developed MACCE during the follow-up. The clinical examination and the measurement of blood laboratory parameters were performed. Age- and sex-adjusted Cox regression analysis were adopted to analyze the correlation between lipoprotein associated phospholipase (Lp-PLA2), C1q/tumor necrosis factorsassociated protein 3 (CTRP-3) and MACCE in T2DM patients aged 40–65 years. The diagnostic efficacy of the respective index was analyzed using the receiver operating characteristic (ROC) curve and the area under curve (AUC). Results After a median 84 months follow-up [42, (32–54)], the levels of new inflammatory factors Lp-PLA2, CTRP-3 and other traditional indices of blood lipids such as HDL-C, LDL-C and ApoB were abnormally expressed in MACCE patients of the positive group of T2DM patients aged 40–65 years. Age- and sex-adjusted Cox regression analysis showed that Lp-PLA2 (HR = 1.007, 95% confidence interval ( CI ): 1.005–1.009, P < 0.001) and CTRP-3 (HR = 0.943, 95% CI 0.935–0.954, P < 0.001) were independently correlated with the occurrence of MACCE. The receiver operating characteristic (ROC) curve analysis showed that Lp-PLA2 and CTRP-3 could strongly predict the occurrence of MACCE (area under ROC (AUC) = 0.81, 95% CI 0.77–0.85, P  < 0.001) (AUC = 0.91, 95% CI 0.89–0.93, P  < 0.001). Combined Lp-PLA2 with CTRP-3 can predict the occurrence of MACCE well (AUC = 0.94, 95% CI 0.93–0.96, P  < 0.001). Conclusions The serum levels of Lp-PLA2 and CTRP-3 were abnormally expressed in MACCE patients of T2DM patients aged 40–65 years, and both of them were correlated with the occurrence of MACCE. The combined detection of Lp-PLA2 and CTRP-3 could improve the diagnostic efficacy of MACCE in T2DM patients aged 40–65 years.