Study On The Tisk Factors Of Diabetic Microvascular Disease And The Correlation Between It And Serum Myocardial Enzymes

BackgroundsThe increase of blood glucose in patients with diabetes mellitus can cause the metabolic disorders of various substances in the body,including the metabolic imbalance of glucose,fat and protein.It can be the long-term result which will cause abnormalities of systemic organs in the body,leading to various complications.In addition to infectious complications,chronic complications involve all important organs of the body that resulted in a decline in quality of life and a drop in lifespan.As a specific complication of diabetes, microangiopathy has a serious impact on the disease progression of diabetes.In this paper, we should make a concrete analysis of the related cases of hospitalized patients who are diagnosed with diabetes mellitus during the period from January to June in 2015.Patients' data is derived from the Endocrinology Department of the Second Affiliated Hospital of Zhengzhou University.We discussed the risk factors of diabetic microangiopathy,in order to carry out targeted guidance and interventions for patients in the process of treatment.This will be beneficial to the clinical prevention and treatment of diabetic complications.Objectives1.To investigate the case rate and risk factors of diabetic microangiopathy [diabetic nephropathy (DN) and diabetic retinopathy (DR)]in patients with diabetes mellitus.2.To analyze the correlation between myocardial enzymes spectrum and diabetic microvascular disease,and to explore the value of myocardial enzymes in the diagnosis of diabetic cardiomyopathy.Objects and MethodsWe should make statistical analysis of the related cases of hospitalized patients who are diagnosed with type 1 diabetes or type 2 diabetes during the period from January 1,2015 to June 30,2015.Patients' data is derived from the Endocrinology Department of the Second Affiliated Hospital of Zhengzhou University.A total of 405 cases were selected,including 238 males and 167 females, their average age is (60.88 +13.757) years old, average course of diabetes is (11.807+8.331)years.Part One:To study the risk factors of diabetic nephropathy (DN) and diabetic retinopathy (DR).All cases were divided into six groups:1) Diabetic nephropathy group (Group DM-DN); 2) Diabetics without nephropathy group (Group DM-nonDN); 3) diabetic retinopathy group (Group DM-DR); 4) Diabetics without retinopathy group (Group DM-nonDR); 5) DMAP group with DR and DN (Group DMAP); 6)Non DMAP group of diabetics patients without DR or DN (Group nonDMAP).Part Two:According to the myocardial enzymes spectrum, all cases were divided into two groups. The cases of normal myocardial enzymes were marked as group A,Tthe cases of abnormal myocardial enzymes were.marked as group B.According to the above grouping situation,the basic situation and clinical indexes were compared between each corresponding group.The results were analyzed by SPSS 22.Results1.Part One:The single factor analysis of DN, DR and DMAP:Among them, the common related factors of these diseases (including DN, DR and DMAP) are the levels of BUN?Cys-C?RBP?LDH?LDH-1?HBDH, the course of diabetes, the case rate of hyperlipidemia?hypertension?abnormal myocardial enzymogram.? Compared to the Group DM-DN and Group DM-nonDN, while there was statistically significant differences in the levels of HbA1c?FBG?AST?Cre?UA? CK?CK-MB?IMA,and the historical cases rates of diabetic retinopathy?cataract between the two groups (P< 0.05).? Compared to the Group DM-DR and Group DM-nonDR, while there was statistically significant differences in the levels of BMI?SBP?UA,the age and sex,and the historical cases rates of diabetic nephropathy?hepatic adipose infiltration? coronary heart disease?cerebrovascular diseases between the two groups (P< 0.05).?Compared to the Group DMAP and Group nonDMAP, while there was statistically significant differences in the levels of HbA1c?Cre, the sex,and the historical cases rates of diabetic neuropathy?coronary heart disease?cerebrovascular diseases between the two groups(P< 0.05).2.Part One:The multi-factor analysis of DN,DR and DMAP:DR?Ccr?RBP? LDH are independent risk factors for DN; the course of diabetes?DN?UA?LDH? HBDH are independent risk factors for DR; DN and DR are risk factors for each other.The course of diabetes?the history of hypertension, the levels of HbA1c?Cre? RBP are independent risk factors for DMAP.These results suggest that the longer the course of diabetes,the history of hypertension,the higher the levels of HbA1c?Cre? RBP,the greater the risk of microvascular disease.3.Part Two:Analysis on the Correlation between myocardial enzymes and DN and(or) DR:There was statistically significant differences between Group A and Group B in the course of diabetes,the age,the levels of AST?UA?Cys?RBP?Ccr, and the case rates of diabetic nephropathy and diabetic retinopathy(P<0.05).Abnormal myocardial enzymes have a weak positive correlation with the course of diabetes,the age,the levels of AST?UA?Cys-C?RBP, and the case rates of diabetic nephropathy and diabetic retinopathy,meanwhile the abnormal myocardial enzymes also have a weak negative correlation with the level of Ccr.4.Analysis on the Correlation between individual items in the myocardial enzymes spectrum and DN and(or) DR:Group DN have a higher trend of levels of LDH?LDH-1?CK?CK-MB?HBDH than Group nonDN,and there was statistically significant differences between the two groups in above clinical indicators (P<0.05). Group DR have a higher trend of levels of LDH?LDH-1?HBDH than Group nonDR,and there was statistically significant differences between the two groups in above clinical indicators (P<0.05).Conclusion1.The common related factors of these diseases(including DN, DR and DMAP) are the levels of BUN?Cys-C?RBP?LDH?LDH-1?HBDH, the course of diabetes, and the case rates of hyperlipidemia?hypertension?abnormal myocardial enzymogram.2.DR?Ccr?RBP?LDH are independent risk factors for DN;3.The course of diabetes?D?UA?LDH?HBDH are independent risk factors for DR;4.DN and DR are risk factors for each other.The course of diabetes?the history of hypertension, the levels of HbAlc?Cre?RBP are independent risk factors for DMAP.These results suggest that the longer the course of diabetes,the history of hypertension,the higher the levels of HbAlc?Cre?RBP,the greater the risk of microvascular disease.5.Abnormal myocardial enzymes have a weak positive correlation with the course of diabetes,the age,the levels of AST?UA?Cys-C?RBP,and the case rates of diabetic nephropathy and diabetic retinopathy.6.Relative to the current diagnostic criteria for diabetic cardiomyopathy, abnormal increase of myocardial enzymes,especially for the anomalies of LDH, LDH-1, HBDH,those can support the diagnosis of diabetic cardiomyopathy.