Association Between Abdominal Vessels’ Diameter And Blood Flow Velocity And Type2 Diabetes Mellitus

Aims:To explore the value of abdominal vessels’ diameters and blood flow velocity in determining risk factors and the predictors of diabetes mellitus(DM)incidence.Methods:According to the criteria of inclusion and exclusion,380 patients with T2DM(T2DM group)and 354 patients without DM(NC group)were selected from January 2016 to January 2021.And T2DM group was divided into two groups according to HbAlc,from low to high respectively:G1<7%,G2≥7%.(1)Basic information,abdominal artery ultrasound parameters and traditional risk factors(TRF)for T2DM were collected.(2)①Data judged as skewed distribution were described as median(P25,P75).And the rank-sum test was used for comparison between 2 group of these data.Statistical data were described by composition ratio,and comparisons between different groups were performed by Chi-square test.②Spearman analysis was used to describe the correlation between ultrasonographic parameters of abdominal vessels and TRF.③Cox regression was used to construct the prediction model of T2DM or poorly controlled T2DM,and the classification efficiency was analyzed.Results:In NC group,there were 354 patients.In DM group,there were 380 patients.Besides there were 187 cases in group G1(HbA1c<7%),193 cases in group G2(HbA1c≥7%).(1)①In DM group,abdominal aortic plaque,maximal systolic flow rate of superior mesenteric artery(SUM)were significantly higher than those in the NC group,and abdominal aorta diameter(AAD),SUM diameter,AAD/BSA were significantly lower than those in the NC group(P<0.01).②In female T2DM group,abdominal aortic plaque,maximal systolic flow rate of SUM were significantly higher than those in the female NC group,and AAD、SUM diameter,AAD/BSA were significantly lower than those in the female NC group(P<0.05).In male T2DM group,abdominal aortic plaque,maximal systolic flow rate of SUM were significantly higher than those in the male NC group,and AAD,AAD/BSA were significantly lower than those in the male NC group(P<0.05).(2)①In G2 group,abdominal aortic plaque were significantly higher than those in G1 group,and AAD,SUM diameter,AAD/BSA were significantly lower than those in G1 group(P<0.05).②In female G2 group,AAD and AAD/BSA were significantly higher than those in female G1 group(P<0.05).In male G2 group,abdominal aortic plaque,maximal systolic flow rate of SUM were significantly higher than those in male G1 group,and AAD,celiac flux diameter,SUM diameter,AAD/BSA were significantly lower than those in male G1 group(P<0.05).(3)Cox regression analysis showed that the risk of diabetes mellitus was associated with AAD,and the hazard ratio(HR)was 1.478 with a 95%confidence interval(95%CI)was(1.164～1.877),which was statistically significant(P=0.001).And then,AAD<1.65cm was defined as model 1.Gender,age,smoking history and drinking history were further adjusted and defined as Model 1A.Model 1B was obtained by adjusting VAI on the basis of Model 1A,and all models had statistical significance(P<0.05).(4)Cox regression analysis showed that SUM peak systolic velocity<129cm/s was correlated with blood glucose fluctuation in T2DM group,and HR(95%CI)was 1.414(1.040～1.923),which was statistically significant(P<0.05).Then,SUM peak systolic velocity<129cm/s was defined as Model 2,and gender,age,smoking history and drinking history were further adjusted and defined as Model 2A.Model 2B was obtained by further adjusting VAI on the basis of model 2A.Both Model 2A and 2B failed to be constructed(P=0.231,0.052).Conclusions:(1)AAD<1.65cm is an independent risk factor for diabetes and can be used for diabetes screening.(2)Compared with the group with larger peak velocity of systolic period in SUM,the smaller group had larger fluctuation of blood glucose,which could be used to assist in judging the severity of diabetes.