The Correlation Between Transcutaneous Oxygen Tension And Microvascular Complications In Type 2 Diabetic Patients

Objective: Microcirculation disorder is the leading cause of diabetic kidney disease,diabetic retinopathy,diabetic peripheral neuropathy.Transcutaneous oxygen pressure measure is a non-invasive,accurate and reusable method,and it also can be a direct reflection of the outer peripheral microcirculation,we studied the predictive value of transcutaneous oxygen pressure about microvascular complications in type 2 diabetic patients.Methods: We recruited 436 patients with T2 DM,collecting their relevant information.Based on the presence of diabetic kidney disease,diabetic retinopathy,and/or diabetic peripheral neuropathy,the patients were divided into groups with and without microvascular complications.The differences between these 2 groups were examined using the chi-square test and the t test.The influencing factors of diabetic microangiopathy were studied using a logistic regression analysis.Results: The subjects were divided into groups with and without microvascular complications,showed that age,gender,DM duration,smoking history,drinking history,history of hypertension,TcPO₂,TBI and Hb A1 c which nine index distribution differences among different groups statistically significant?P<0.05?.Put the univariate analysis meaningful indicators into multivariate regression analysis showed that sex,HbA1 c,DM duration,smoking history and TcPO₂ these five indicators are the independent risk factors of the complication in T2DM?P<0.05?.It should be noted that,the results suggested only five indicators,namely,sex,HbA1 c,diabetes duration,smoking history,and TcPO₂ were statistically significant.The risk of microvascular complications was 3.03 times higher in male patients than in female patients?OR=3.025,95% CI: 1.097-8.342?.Patients with higher HbA1 c levels were also more prone to developing microvascular events?OR=1.306,95% CI: 1.073-1.589?,as were diabetic patients with longer disease courses?OR=1.146,95% CI: 1.060-1.238?.Moreover,the risk of developing microvascular events was 2.77 times higher in smoking patients than in non-smoking patients?OR=2.765,95% CI: 1.058-7.225?and 10.16 times higher in the low TcPO₂ group than in the high TcPO₂ group?OR=10.157,95% CI: 4.602-22.418?.In addition,TcPO₂ was used as the observation indicator in the ROC curve analysis.The diagnostic area under the curve?AUC?value for the entire population was 0.799?95% CI: 0.746-0.852?,and the best threshold value was 50 mm Hg?sensitivity 0.766,specificity 0.702,positive predictive value 89.6%,and negative predictive value 45.3%?.Using this cutoff?50 mmHg?,the patients were divided into a high TcPO₂ group?>50 mmHg?and a low TcPO₂ group??50 mm Hg?.The incidence of microvascular complications in the low TcPO₂ group was significantly higher than that in the high TcPO₂ group?P<0.05?.Conclusion: This study showed that TcPO₂ was significantly negatively associated with the occurrence of microvascular events in type 2 diabetic patients and that TcPO₂ may be an independent risk factor for predicting the occurrence of microvascular complications in these patients.These results suggest that for type 2 diabetes mellitus with clinically reduced TcPO₂,we should pay close attention to the occurrence of microvascular complications and engage in early prevention.