| Part 1: Association of insulin-resistance index with blood lipid,blood protein and blood cells among type 2 diabetes mellitus patientsObjective: To explore modified insulin-resistance index [HOMA-IR(C-P)] associated with some clinical indicators regard to metabolism or immune by collecting the data of type 2 diabetic patients,and to improve their metabolism-immunologic function.Methods: Twenty-nine type 2 diabetic patients who visited Department of Endocrinology in The First Affiliated Hospital of Guilin Medical College were enrolled for the present study.Type 2 diabetes mellitus(T2DM)was diagnosed basing on World Health Organization criteria in 1999.As different body mass index(BMI),all subjects were divided into one non-obesity group(BMI<25 kg/m2,n=15)and another obesity group(BMI≥25 kg/m2,n=14).These subjects’ blood samples were obtained in the morning after an overnight fast,and had complete physical examination.Enumeration data were presented as means ± standard deviation.Categorical data were presented as ratio.All abnormal distribution was transformed into natural logarithm.T-tests were performed to compare data between two groups.Chi-square tests were used to compare percentage.Pearson correlation and stepwise linear regression were also performed.All statistical analyses were accomplished with the version 18.0 of SPSS for Windows software.Results: All clinical data observed were similar between the non-obesity group and obesity group(P>0.05).Pearson correlation analysis: For T2 DM patients in the non-obesity group,there were positive correlation between the levels of HOMA-IR(C-P)and age(r=0.784,P=0.001),absolute immature granulocyte(IG)(r=0.603,P=0.029),the ratio of immature granulocyte(IG%)(r=0.579,P=0.038).For T2 DM patients in the obesity group,there were positive correlation between the levels of HOMA-IR(C-P)and insulin resistance index [HOMA-IR](r=0.667,P=0.008),triglyceride(TG)(r=0.597,P=0.031),total cholesterol(TC)(r=0.628,P=0.022),low-density lipoprotein cholesterol(LDL-C)(r=0.628,P=0.022),apolipoprotein-B(APO-B)(r=0.586,P=0.035),serum albumin/globulin(A/G)(r=0.595,P=0.025),and were negative correlation between the levels of HOMA-IR(C-P)and serum immunoglobulin G(Ig G)(r=-0.586,P=0.043).Stepwise linear regression: for obese T2 DM patients,HOMA-IR(C-P)and A/G or absolute monocyte(MON)exist linear correlation.The linear regression formula was: Y=-4.961+3.156×A/G+7.028×MON.Conclusions:(1)In the non-obesity group for T2 DM patients,their HOMA-IR(C-P)was positively related to age,IG,IG%,respectively.While in the obesity group,their HOMA-IR(C-P)was positively related to TG,TC,LDL-C and APO-B,A/G was one factor to effectively influence HOMA-IR(C-P),and associated positively with it,while MON was another major factor.In addition,Ig G was negatively associated with HOMA-IR(C-P).(2)There was no statistical significance between the non-obesity and obesity groups for T2 DM patients’ blood lipid,blood protein,blood cells.Part 2: Prevalence and risk factors research of cardiovascular disease among type 2 diabetes patientsObjective: To quantify the distribution of type 2 diabetes mellitus(T2DM)patients who had ≥1 cardiovascular disease(CVD)risk factors,and analyze the main independent risk factors.Methods: Three hundreds and eighty-two 2 diabetic patients who visited an hospital were enrolled for the present study.Type 2 diabetes mellitus(T2DM)was diagnosed basing on World Health Organization criteria in 1999.We examined the prevalence of CVD risk factors clustering among these T2 DM patients aged 30 to 89 years.The prevalence of each CVD risk factor(dyslipidemia,hypertension,overweight,current smoking,and current alcohol intake)was determined for men and women,separately,and by age grouping(30 to 59,60 to 74,78 to 89 years).The prevalence of 0,1,2 and ≥3 CVD risk factors was determined for the overall study population by age groups and for men and women,separately.The adjusted odds ratios and 95% confidence interval(95%CI)of having 1,2 and ≥3 major CVD risk factors versus no CVD risk factor were determined from multivariable logistic-regression models that included age group and sex.Results: Overall,72.75%,59.16%,73.82%,15.71%,3.66% T2 DM patients had dyslipidemia,hypertension,overweight,current smoking and current alcohol intake,respectively.For men,7.06%,16.47%,33.53%,42.94% T2 DM patients had 0,1,2,≥3 CVD risk factors.For women,5.67%,10.85%,37.26%,46.23% T2 DM patients had 0,1,2,≥3 CVD risk factors.The female prevalence of dyslipidemia,hypertension and overweight was higher than the male(dyslipidemia: P=0.003<0.01;hypertension: P=0.027<0.05;overweight: P=0.128).The male prevalence of current smoking and current alcohol intake was higher than the female(current smoking: P<0.001;current alcohol intake: P=0.039<0.05).According to age grouping(30-59 years,60-74 years,75-89 years)of T2 DM,the prevalence of hypertension increased while the prevalence of current smoking declined as their age became older(hypertension: P=0.001<0.01;current smoking: P=0.001<0.01).The male prevalence of current smoking in different age groups was higher than the female(30-59 years: P=0.004<0.01;60-74 years: P<0.001;75-89 years: P=0.012<0.05).In a multivariable model including age and sex,based on the age ranged from 30 to 59 years,the independent risk factor of T2 DM patients with 2 CVD risk factors was the age ranged from 60 to 74 years(P=0.001<0.01)which was also the independent risk factor of T2 DM patients with 3 CVD risk factors(P<0.001).Conclusions:(1)Among all T2 DM patients with CVD history in this study,the female prevalence of dyslipidemia and hypertension was higher significantly while that of current smoking was lower significantly than the male.The prevalence of hypertension increased while the prevalence of current smoking declined as their age became older.The male prevalence of current smoking in different age groups was higher than the female.(2)The proportions of T2 DM patients with ≥3 CVD risk factors were both the highest in men or women.The age range of T2 DM patients with ≥3 CVD risk factors was mainly in 60-74 years which was also the independent risk factor of T2 DM patients with ≥3 CVD risk factors. |
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