Analysis of the correlation between plasma coagulation factor VII, PAI-1, and uric acid with insulin resistance and macrovascular complications in elderly patients with type 2 diabetes.

Abstract

To analyze the correlations between plasma coagulation factor VII (FVII), plasma plasminogen activator inhibitor-1 (PAI-1), uric acid, and insulin resistance (IR) and diabetic macroangiopathy (DMAP) in elderly patients with type 2 diabetes mellitus (T2DM). The clinical data of 112 elderly T2DM patients admitted to our hospital between March 2017 and March 2020 were enrolled. Subgroups were allocated based on the inclusion and exclusion criteria, body mass index (BMI), homeostasis model assessment (HOMA)-IR and the presence of DMAP. The patients were allocated as the study objects (T2DM group, n=90), simple obesity (BMI ≥25 kg/m2, n=25), simple non-obese (BMI <25 kg/m2, n=22), obesity with DMAP (n=24), and non-obese with DMAP (n=19). Meanwhile, data from 50 healthy controls from physical examinations were employed. The levels of FVII, PAI-1, HOMA-IR and uric acid were determined. Pearson correlation analysis was used to measure the correlations, and the receiver operating characteristic (ROC) curve was used to determine the predictive value of detection indexes. The levels of FVII, PAI-1, and uric acid in the T2DM group were higher than those of the control group (P<0.05). In terms of the levels of FVII, PAI-1, and uric acid: simple non-obese group < simple obese group < non-obese with DMAP group < obese with DMAP group (P<0.05). The levels of FVII, PAI-1, and uric acid in T2DM patients were positively correlated with BMI and Homeostasis model assessment (HOMA)-IR (P<0.05). The ROC curve results showed that the area under the curve (AUC) for FVII, PAI-1, and uric acid separately, as well as a combination of the three were 0.930, 0.831, 0.888, and 0.997, respectively. FVII, PAI-1, and uric acid levels are elevated in elderly T2DM patients. The levels of FVII, PAI-1, and uric acid are closely related to IR in elderly T2DM patients. The combination of TFVII, PAI-1, and uric acid levels can be used as an effective measure to predict patients with DMAP. Furthermore, the levels of these markers should be promptly measured in a clinical setting for early intervention and improvement of the patient's outcomes.