Soluble ST2 is associated with increased carotid intima-media thickness in patients with type 2 diabetes mellitus: A case-control study

Soluble suppression of tumorigenicity 2 (sST2) is a free form of membrane-bound ST2, which is a member of the interleukin-1 receptor family. Previous research has shown that sST2 is associated with diabetes, but cardiovascular risk factors have not been established.To analyze the relationship between sST2 and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM).After screening, a total of 118 subjects with T2DM were divided into 2 groups according to the measurement of CIMT (normal CIMT (NCIMT), n=58; abnormal CIMT (ACIMT), n=60), and 60 healthy subjects (normal control (NC), n=60) were recruited in this study. CIMT was measured by a color Doppler ultrasound, and sST2 and other metabolic parameters were measured as well.The median concentration of sST2 was elevated in the ACIMT group (31.30ng/ml) compared with the NCIMT group (28.29ng/ml, P<.01) and the NC group (20.15ng/ml, P<.01). After adjustment for age and sex, log sST2 was strongly associated with smoking history (beta=0.197, 95% CI, 0.084-0.311, P<.01), FPG level (beta=0.302, 95% CI, 0.162-0.442, P<.01) and HbA1c level (beta=0.296, 95% CI, 0.165-0.426, P<.01) and negatively correlated with HDL level (beta=-0.153, 95% CI, -0.259 to -0.046, P<.01). Furthermore, sST2 level was a risk factor for increased CIMT in patients with T2DM.Increased sST2 level not only was associated with indicators of glucose and lipid metabolism but also was a risk factor for increased CIMT in patients with T2DM. Thus, sST2 may be a potential novel marker to assess the progression of diabetic macrovascular complications.