Association Between Brachial-ankle Pulse Wave Velocity And Early Diabetic Nephropathy In Type 2 Diabetes

Objective:Through the analysis of brachial ankle pulse wave velocity and correlation ofearly type 2 diabetic nephropathy, to understand the degree of stiffness in patients with type 2 diabetic nephropathy in early stage of peripheral artery.Methods:Choose 60 patients with type 2 diabetes hospitalized at the First Hospital of Dalian Medical University three hospital department of Endocrinology from July 2014 until January 2015 because of poor glycemic control.All patients were detected three times urine MA, urine CRE in morning, and calculate 3 times the average of MA/CRE,according to the urine MA/CRE divides the subjects into two groups, one group for early diabetic nephropathy group(DN group,early diabetic early, nephropathy), between urine MA/CRE between 30-300 g/mg, at the same time diabetic retinopathy(DR).Another group without diabetic nephropathy group(DN group, non diabetic nephropathy),and the measurement of diastolic blood pressure(DBP), pulse pressure(PP),systolic blood pressure(SBP),mean arterial pressure(SBP-DBP),waist circumference(WC) were recorded and body mass index(BMI). Our Institute ofnuclear medicine and laboratory biochemical index determination, blood triglyceride(TG),C reactive protein(CRP),high density lipoprotein cholesterol(HDL-C), blood urea nitrogen(BUN),fasting blood qlucose(FPG),urine MA/Cre, fasting C peptide(FCP),creatinine(Cre), total cholesterol(TC), 2 hour postprandial C peptide(2h CP),blood uric acid(SUA),low density lipoprotein cholesterol(LDL-C), glycosylatedhemoglobin(Hb A1c). Applicate the automatic arteriosclerosis detector, detect the brachial ankle pulse wave velocity(brachial-ankle pulse wave velocity, ba-PWV),comparative analysis of two groups of the above indexes, so as to grasp the degree of peripheral arterial sclerosis. The ba-PWV as the dependent variable, 2 h CP, diastolic blood pressure, fasting CP, age, pulse pressure, systolic blood pressure, urine MA/Cre,BUN, mean arterial pressure, blood uric acid, FPG as independent variables, statistical analysis, observation indexes and whether ba-PWV.Results:1.Found in the comparison between the two groups in ba-PWV, all patients(with or without nephropathy), were significantly higher than the normal value of 1400 cm /s,and ba-PWV in early DN group(1877.50±266) was significantly higher than that in non DN group in early ba-PWV(1472.3 ± 190.99), with statistical difference significance(P < 0.01).2.Between the two groups in the clinical biochemical indexes comparison found, DN group early diastolic blood pressure(89 ± 16.64), mean arterial pressure(105.67 ±18.47)and FPG(10.02±2.88) were higher than those in non DN group, early diastolic blood pressure(88.17 ± 13.42), mean arterial pressure(104.66 ± 14.35),FPG(9.92 ±3.75), the difference is statistically significant(P < 0.05).3.Using statistical linear stepwise regression analysis indicated that, the ba-PWV as the dependent variable, BUN, uric acid, FPG, fasting CP,2h CP, MA/Cre, age,systolic blood pressure,mean arterial pressure,pulse pressure,diastolic blood pressure, as independent variables, the results show that: the analysis of age, systolic blood pressure,urine MA/Cre for the influencing factors of ba-PWV. The regression equation is Y =-517.900+ 9.591X1 + 10.790X2 +23.221X3 + 34.520X4(X1:age, X2: systolic, X3: ACR,X4: BUN)Conclusion:1.Peripheral arterial stiffness increased in patients with T2 DM, and the early peripheral arterial stiffness associated with type 2 diabetic nephropathy.2.With the increase of T2 DM in patients with microalbuminuria, increased systolicblood pressure and age, peripheral arterial stiffness was significantly increased.