Relationship Between BMI Level And Vascular Complications In Type 2 Diabetics

Objective: To investigate the relationships between different body mass index(BMI)levels and vascular complications in diabetic patients.Methods: A total of 3224 patients with type 2 diabetes mellitus were enrolled in this retrospective study.Among them,there were 1635 males and 1589 females.The mean duration of the diabetes was 7.89±6.71 years,and mean BMI was 24.56±3.65 kg/m2.Patients' generally baseline information,signs and symptoms of nervous system,some biochemical indicators such as glycosylated hemoglobin(Hb A1c),blood glucose,blood lipid,urinary albumin creatinine ratio,estimated glomerular filtration rate,and ultrasound examination of the carotid artery,Ankle brachial index(ABI)have been collected.According to the levels of BMI were divided into five groups,BMI quintiles 1–5 were defined as <21.62 kg/?,21.62-23.50 kg/?,23.51-25.16 kg/?,25.17-27.33 kg/?,>27.33 kg/?.SPSS18.0 software was used to analyze the data,and the correlation between BMI level and DM vascular complications was analyzed by Logistic regression and forest map analysis.Results: In the patients,diabetic peripheral neuropathy(DPN)was present in 43.2%,diabetic kidney disease(DKD)in 19.4%,retinopathy(DR)in 19.1%,carotid atherosclerotic plaque in 26.9%,and peripheral arterial disease(PAD)in 8.1%.With the increase of BMI,the prevalence of hypertension increased.Among the five groups,the detection rates of DPN were 48.8%,42.3%,38.9%,40.2%,and 45.8%(P=0.002);the detection rates of carotid atherosclerotic plaque were 24.8%,26.8%,23.3%,26.5%,and 33.2%(P=0.001);and the detection rates of PAD were 9.8%,6.8%,6.5%,7.3%,and 9.9%(P=0.048),respectively.No significant differences in the detection rates of DKD and DR were observed in the five groups.Compared to the P?20 group,the odds ratios(OR)for DPN were 0.747(95% CI: 0.588-0.949),0.661(0.518-0.843),0.680(0.532-0.869),and 0.867(0.678-1.109)in the P>20,?40 group,P>40,?60 group,P>60,?80 group,and P>80 group,respectively.The ORs for PAD in the P>20,?40 group,P>40,?60 group,P>60,?80 group,and P>80 group were 0.647(0.421-0.993),0.591(0.381-0.915),0.605(0.391-0.936),and 0.778(0.518-1.169).In the P>80 group,the OR for DKD was 1.666(1.200-2.315),and it was 1.406(1.073-1.844)for carotid atherosclerotic plaque,after adjustments for gender,age,DM duration,Hb A1 c,SBP,TG,and smoking.Conclusion: In patients with T2 DM,the relationships between different BMIs and vascular complications are not the same.A U-shaped relationship is observed between BMI and DPN as well as BMI and PAD.BMI is positively correlated with DKD and carotid atherosclerotic plaque;however,it is not correlated with DR.