Objective To explore the correlations of levels of homocysteine (Hcy), glycosylated hemoglobin (HbA1c) and lipoprotein associated phospholipase (Lp-PLA2) with diabetic peripheral vascular disease.

Methods A total of 206 patients diagnosed as type 2 diabetes (T2DM) were selected as research subjects.According to different results of the examination, they were divided into normal group (normal carotid artery patients, 116 cases) and atherosclerotic plaque group (diabetes mellitus combined with atherosclerotic plaque patients, 90 cases).The correlations between various indicators and carotid intima media thickness (IMT) in T2DM patients, the serological indicators (HbA1c, Lp-PLA2, Hcy) and the occurrence of adverse events were compared, and the influencing factors of vascular complications in T2DM patients were explored.The correlations of coronary artery microcirculation resistance index (IMR) with Lp-PLA2 and Hcy, and the risk factors of IMR elevation by multivariate Logistic regression analysis were explored.

Results There were significant differences in hypersensitive C-reactive protein (hs-CRP) and uric acid levels between the atheromatous plaque group and the normal group (P < 0.05).There were statistically significant differences in HbA1c, Lp-PLA2 and Hcy between the two groups at the 6 and 12 month of follow-up (P < 0.05).The incidence of adverse events at 6 and 12 months in the atheromatous plaque group was higher than that in the normal group (P < 0.05).Plasma Lp-PLA2 was positively correlated with IMT of common artery, external artery and bilateral internal carotid artery in T2DM patients (P < 0.01).There was significant positive correlation between uric acid and IMT of right common carotid artery, external artery and internal artery (P < 0.05).The level of 2 h postprandial C peptide was significantly positively correlated with IMT of left external carotid artery, internal carotid artery and right external carotid artery (P < 0.05).Lp-PLA2 and hs-CRP were the main influencing factors of diabetic vascular complications.Hcy, Lp-PLA2 were significantly positively correlated with IMR (P < 0.01), there was a significant negative correlation between coronary blood flow reserve (CFR) and IMR (P < 0.01).The risk factors for increase of IMR were Hcy and age, and the protective factors were HDL-C and CFR (P < 0.05).

Conclusion HbA1c, Lp-PLA2 and Hcy are independent risk factors of diabetic peripheral vascular disease.