The Clinical Characteristics Analysis Of Different Blood Pressure Levels In Type2Diabetes Mellitus

Purpose:To compare the general clinical information, changes of metabolicindicators among different blood pressure levels in type2diabetes mellitus，andtheir relevance to blood pressure,To guide the clinical prevention and treatmentof hypertension in patients with diabetes.Method:Four hundred and eighteen patients with type2diabetes were selectedwho stayed in Department of Endocrinology and Metabolism of First Hospitalof Jilin University from December in2010to September in2012,30-77yearsold.Record general clinical information: age,gender,duration ofdiabetes,smoking historyand so on.The next morning after12hours’ fasting,draw venous blood and inspected, measured serum creatinine(SCr),triglycerides(TG), low density lipoprotein cholesterol(LDL-C), highdensity lipoprotein cholesterol(HDL-C), uric acid (UA), fasting plasmaglucose (FPG),thyroid stimulating hormone(TSH), thyroid hormones freetri-iodothyronine(FT3), free thyroxine(FT4).Detect Heart Dopplerultrasound,carotid color ultrasonography.Designate personnel to measure bloodpressure,patients were divided into three groups according to bloodpressure:normotensive group,prehypertension group,hypertension group. Usethe SPSS16.0,compare the general information, indicators, andechocardiography between groups.Give the relevance analysis to the possiblefactors of elevation of blood pressure in type2diabetes mellitus and thenanalyze the high risk factors with multiple stepwise regression. Result:1.General Clinical Information:The difference of gender ratio andsmoking history were not statistically significant (P>0.05). Age, duration ofdiabetes,BMI of three groups were significantly different(P<0.01).2.Laboratory Index:Serum creatinine(Scr), blood uric acid,A/C,TC ofthree groups were significantly different(P<0.01).There were statisticaldifferences in LDL-C,PBG among three groups(P<0.05).But there were nosignificant difference in BUN,24-hour urinary protein,24hours urinary traceprotein,TSH,FT3,FT4,FBG,HbA1c among three groups (P>0.05).3.Examination result:IMT,LAD,IVST,LVEDD,LVPW,A peak,aorticmaximum velocity,pulmonary maximum velocity of three groups weresignificantly different(P<0.01).But there were no significant difference inAORD,RVID,FS,EF,E peak among three groups (P>0.05).4.Related-to relationships: SBP and age, duration of diabetes,BMI,Scr,blood uric acid,TC,LDL-C,PBG,IMT,LAD,IVST,LVEDD,A peak,aorticmaximum velocity were positively correlated (P<0.01or P<0.05). DBP andBMI,Scr,blood uric acid,IMT,LAD,IVST,LVEDD,A peak,pulmonary maximumvelocity were positively correlated (P<0.01or P<0.05).Multiple LinearRegression shows that age,BMI,PBG,IMT,IVST,A peak were risk factors forthe rise of SBP,BMI、Scr、IVST were risk factors for the rise of DBP in type2diabetes mellitus.Conclusion:1.BMI was risk factor for the rise of SBP and DBP in type2diabetesmellitus.2. With hypertension occurrence in Diabetic patients, the change ofcardiac structure and function develops along with.With blood pressure rose,heart change main manifested for left atrial diameter increased, and theinterventricular septum thickness increased and related cardiac function decreased.3.In patients with type2diabetes,IMT, blood uric acid inpre-hypertension were changed, indicating that pre-hypertensive group may bewith elevated blood pressure target organ damage, pre-hypertension Can not beoverlooked.4.Subclinical hypothyroidism proportion is the largest in Diabetic patientswith thyroid function change,and may be associated with diabetesitself.whether related with blood pressure, remains to be further confirmed by alarge number of prospective study.