Study On Homocysteine, Cystatin C, HOMA-IR And Type 2 Diabetes Micro Lesions In Patients With Vascular Disease Relationship

Objective:Analysis of type 2 diabetes mellitus (T2DM) homocysteine and diabetic microangiopathy patients (Hcy), Cystatin C (CysC), homeostasis model assessment of insulin resistance index (HOMA-IR) changes and clinical significance of the constituent ratio of gender, and between the two, to explore the risk factors of T2DM in micro vascular lesions.Methods:From 2013 January to 2014 November in 102 cases of T2DM patients in Guangxi Yulin First People’s Hospital Endocrinology Department of the hospital. Divided into two groups:none of the T2DM patients with microangiopathy in 50 cases, T2DM group of 52 patients with microangiopathy. All the statistical study of gender, age, course of disease, blood pressure, body mass index (BMI) and other general index, serum Hcy, CysC, fasting blood glucose, fasting insulin, total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), glycosylated hemoglobin (HbAlc) level and the calculation of HOMA-IR, the the results were compared between the two groups. The dependent variable is T2DM for microvascular disease, all variables by univariate Logistic regression analysis, screening of the indicators were statistically significant, multivariate analysis by Logistic regression model, to explore the related risk factors of T2DM microvascular disease.Results:(1)Numerical T2DM microangiopathy group in age, course of disease, HbA1c, TC, TG were higher than that in T2DM group, the difference was statistically significant (P< 0.05); and no significant difference between the two groups of BMI, LDL value, SBP (P> 0.05).(2)Pure T2DM group and T2DM group in the micro vascular disease sex ratio had no significant difference, X2=3.25, P> 0.05.(3)T2DM microvascular complications in group CysC, Hcy levels were significantly higher than that in T2DM group, P< 0.05; there were no significant difference between the two groups (P> 0.05) HOMA-IR.(4)Logistic regression analysis showed that:the dependent variable has no T2DM microangiopathy, single factor regression analysis showed correlation with age, course of disease, HbA1c, Hcy, CysC, TC, TG and T2DM microangiopathy (P< 0.05), then the Logistic regression analysis, multi factor index above shows the results:HbA1c, TC, TG, course of disease, Hcy is T2DM micro vascular risk factors (P< 0.05), including:TC value of OR was 1.42 (95% confidence interval OR,1.118-1.807); TG OR= 0.695 (95% confidence interval OR,0.539-0.896); Hcy OR a value of 1.189 (95% confidence interval OR,1.018-1.388). Dummy variables (including age, course of disease, HbA1c) regression analysis showed:Compared with the duration less than 5 years of T2DM patients, duration of 5-10 years of T2DM patients (or=3.74,95% CI: 1.09 or-12.80) and 10 years above in T2DM patients (OR=29.29, or 95%CI:2.10-407.61) occurred micro vascular disease risk increased significantly (P< 0.05). And HbAlc below 7.3% of T2DM patients were compared and HbAlc was 7.3%,8.4% in patients with T2DM or value had no statistical significance (P> 0.05), but HbAlc levels higher than the 8.4% (OR=18.45, or 95%CI:1.93-176.36) occurred in micro vascular disease risk increased significantly (P< 0.05).The OR values of different age groups were not statistically significant (P> 0.05).Conclusion:(1)Elevated T2DM in patients with age, duration, HbA1c, TC, TG levels, the incidence of microvascular complications increased.(2)Hcy, serum CysC level was a significant predictor of T2DM microvascular disease, suggesting that Hcy, CysC detection of T2DM positive patients, early identification with and without diabetic microangiopathy. In this study, there was no obvious correlation between HOMA-IR level and T2DM micro vascular lesions.(3)This study found that the course of disease, HbA1c, TC, TG, Hcy are risk factors of T2DM microvascular disease, and more than 10 years duration of T2DM patients significantly increased the risk of microvascular complications, suggesting that in addition to the strict control of blood glucose, HbAlc, TC and TG, decrease the level of Hcy, which can contribute to the repression of T2DM micro vessel the occurrence and development of disease.