LAUSR

OBJECTIVE To evaluate the correlation of circulating C1q tumor necrosis factor-related protein 4 (CTRP4) with coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM). METHODS Totally 240 individuals with T2DM were enrolled in our center between January 2020 and December 2020. They were assigned into two groups, including the CAD and non-CAD groups, based on coronary angiography or computed tomography angiography (CTA) findings. Serum CTRP4 levels were detected by ELISA kit. Association of CTRP4 with CAD was determined by logistic regression analysis. The predictive value of CTRP4 for CAD was calculated by receiver operating characteristic (ROC) curve analysis. RESULTS Median serum CTRP4 amounts were markedly elevated in the CAD group in comparison with the non-CAD group (10.37 versus 3.75 ng/ml, P<0.01). Binary logistic regression indicated that CTRP4 was associated with CAD and even the amount of coronary artery lesions (P<0.05). In ROC curve analysis, the area under the ROC curve (AUC) was greater for CTRP4 compared with HbA1c or CRP (0.87 versus 0.74, 0.87 versus 0.80, P<0.01). The AUC for CTRP4 and HbA1c in combination was larger than that obtained for CTRP4 combined with CRP (0.91 versus 0.87, P<0.01). According to maximum Youden index criteria, the optimal cutoff of CTRP4 was 5.42 ng/ml, which yielded a sensitivity of 84.4% and a specificity of 76.7% in predicting CAD in T2DM cases. CONCLUSIONS Serum CTRP4 levels are positively correlated with CAD occurrence and severity. Combining CTRP4 and HbA1c has a better predictive value for CAD in T2DM patients.