The Relationship Between Oxidized Low Density Lipoprotein And Lower Extremity Arterial Disease In Type 2 Diabetic Patients

Objective:With the increase in obesity and sedentary lifestyle changes,the incidence of type 2 diabetes(T2DM)is increasing globally.Lower extremity arterial disease(LEAD)is a common complication of diabetes,and a large body of evidence-based medical evidence supports early diagnosis and intervention to improve outcomes.This study aims to exploring the relationship between oxidized low density lipoprotein(ox-LDL)and lower extremity arterial disease(LEAD)in type 2 diabetic patients.Methods: 198 patients with T2 DM who were hospitalized from November 1,2017 to November 30,2018,were selected from the Department of Endocrinology,Hebei General Hospital.After informed consent,inquire,measure and record general information such as height,weigh,smoking status,blood pressure,etc.All patients were performed color doppler ultrasound examination of lower limb arteries for definite diagnosis.According to the results of lower limb artery ultrasound,the patients in group DM with type 2 diabetes mellitus were not associated with lower limb artery disease,group AP with type 2 diabetes mellitus with lower limb artery plaque without vascular occlusion,and group AO with type 2 diabetes mellitus with lower limb artery occlusion.At the same time,all patients with lower extremity arterial plaques were classified into stable plaques and unstable plaques according to the results of ultrasound.Samples of elbow venous blood were collected after 8 to 12 hours fasting,and indexes such as ox-LDL,coagulation,blood lipids and blood glucose were measured.Meanwhile,electroencephalography was performed on all the subjects to explore and analyze the relationship between them and lower limb artery disease.Statistical results were analyzed using SPSS25.0 software.Results:1.Factors among the three groupsCompared with DM group,AP group had higher HbA1 c and fibrinogen,longer duration of diabetes and older age(P<0.05).Compared with the DM group,the AO group had higher levels of ox-LDL,D-dimer,fibrinogen,age,peripheral neuropathy and duration of diabetes(P<0.05),but lower levels of BMI and diastolic pressure than the DM group(P<0.05).Compared with the AP group,the AO group had higher levels of ox-LDL,D-dimer,age,diabetic peripheral neuropathy than the AP group(P<0.05),but the AO group had lower levels of BMI and diastolic pressure than the AP group(P<0.05).Smoking status and lipoprotein(a)gradually increased from DM group to AP group to AO group,but it was not statistically significant.Other lipid indicators,blood glucose,uric acid,gender,and systolic blood pressure did not show statistical significance.2.Comparison of the characteristics of lower limb arterial plaquesThe incidence of unstable plaque in AO group(52.08%)was significantly higher than that in AP group(31.52%)(P<0.01).The level of ox-LDL in the unstable plaque group was higher than that in the stable plaque group,but the results did not show significant difference(P=0.29).3.Risk factors for lower extremity arterial diseaseMultivariate Logistic regression analysis showed that ox-LDL AP group(OR=1.042,P<0.05),ox-LDL AO group(OR=1.073,P<0.01);After adjusting for age,disease course,BMI,HbA1 c and other factors,a multivariate Logistic regression model was established.ox-LDL AP group(OR=1.058,P<0.05),AO group(OR=1.081,P<0.01).Conclusion:1.Type 2 diabetes mellitus patients with arterial occlusion in LEAD have higher levels of ox-LDL,fibrinogen and D-dimer,older age,longer duration of diabetes,higher incidence of peripheral neuropathy,and lower BMI and diastolic pressure.2.The incidence of unstable plaques is higher in type 2 diabetes mellitus patients with lower limb arterial occlusion.3.Multivariate logistic regression analysis,ox-LDL is an important risk factor for type 2 diabetes mellitus patients with lower extremity arterial disease.