Abstract:

Objective    To investigate the changes of serum concentrations of soluble CD40 ligand (sCD40L) and characteristics of carotid atherosclerosis in type 2 diabetics with acute cerebral infarction， and then to explore the relationship between serum soluble CD40 ligand and carotid plaque stability. Methods    69 patients of  type 2 diabetes mellitus with acute cerebral infarction（DACI group）， 32 subjects with simple type 2 diabetes mellitus（DM group）， and 28 normal controls（NC group）were included. Serum levels of soluble CD40 ligand(sCD40L) were measured by enzyme-linked immunosorbent assay(ELISA).Fasting blood glucose， lipid， and glycohemoglobin A1c were detected. Intima-media thickness (IMT)， plaque echogenicity and morpholog were detected by duplex color doppler ultrasound and the Crouse score was calculated. DACI group  was divided into the stable plaque subgroup and the unstable plaque subgroup according to ultrasound results. Results    There were  significant differences in  sCD40L， IMT， the prevalence of carotid plaques and Crouse score among the three groups(P＜0.05). Compared with NC group  and DM group， DACI group mainly exhibited unstable plaques. Furthermore， serum sCD40L levels in patients with unstable plaques were higher than those with stable plaques (P＜0.05). The level of serum sCD40L was positively related with IMT（r=0.733，P＜0.01），　Crouse score（r=0.645, P＜0.01），　HbA1c（r=0.272，P＜0.05），　and triglyceride（TG）（r=0.276，P＜0.05）. Conclusion    Among type 2 diabetic patients， high-circulating sCD40L levels may promote carotid atherosclerosis and carotid plaque instability.

Key words: Type 2 diabetes mellitus; Cerebral infarction; CD40 ligand; Carotid artery disease; Atherosclerosis