Serum BAFF and GDF11: cross-sectional associations with glycolipid metabolism and subclinical carotid artery wall thickening in elderly type 2 diabetes patients.

BACKGROUND: Subclinical carotid artery wall thickening (SCWT) is a macrovascular complication in elderly patients with type 2 diabetes mellitus (T2DM), linked to chronic inflammation and metabolic dysregulation. The cytokines B-cell activating factor (BAFF) and growth differentiation factor 11 (GDF11) are involved in immune-metabolic pathways, but their combined associations with glycolipid metabolism and SCWT in elderly T2DM patients are not well characterized. This study aimed to investigate these associations. METHODS: In this cross-sectional observational study, 205 elderly patients with T2DM and 150 age-matched healthy controls were enrolled. Serum concentrations of BAFF, GDF11, and glycolipid parameters were measured. Carotid intima-media thickness (cIMT) was assessed via ultrasound in the T2DM group only, with SCWT defined as cIMT > 1.2 mm. Statistical analyses included Pearson correlation and multivariate logistic regression. RESULTS: Compared to controls, T2DM patients had higher levels of BAFF, FPG, 2hPPG, HbA1c, TC, TG, and LDL-C, and lower levels of GDF11 and HDL-C (all P < 0.001). BAFF levels correlated positively with FPG, 2hPPG, HbA1c, TC, TG, and LDL-C, and negatively with HDL-C, while GDF11 showed the opposite correlation pattern (all P < 0.05). SCWT was present in 87 patients (42.4%). The SCWT subgroup had higher BAFF and lower GDF11 than T2DM patients without SCWT (both P < 0.001). Multivariate analysis showed that longer diabetes duration, higher HOMA-IR, and elevated BAFF were independently associated with increased odds of SCWT, while higher GDF11 was associated with decreased odds. CONCLUSION: Elevated BAFF and reduced GDF11 are associated with dysregulated glycolipid metabolism and with the presence of subclinical carotid artery wall thickening in this elderly T2DM cohort. These findings suggest potential roles for these cytokines in diabetic macrovascular pathology.