The Correlation Between Red Blood Cell Distribution Width And Diabetic Microangiopathy

Objective: In this study,we collected the general conditions and clinical indicators of patients with type 2 diabetes mellitus(T2DM)and early type 2 diabetic nephropathy and diabetic retinopathy,and explored the risk factors of type 2 diabetes mellitus complicated with different microangiopathy in hospitalized patients.And the correlation between red blood cell distribution width variation coefficient(RDW-CV)and different microvascular lesions of type 2 diabetes,providing ideas for clinical diagnosis.Methods: A total of 300 patients with type 2 diabetes admitted to our department of endocrinology from October 2017 to October 2018 were enrolled.They were divided into diabetic group(Diabetes mellitus,group A,n=75)and early diabetic nephropathy(Diabetic nephropathy).Group B,n=75),Diabetic retinopathy(group C,n=75),diabetic retinopathy combined with early nephropathy group(group D,n=75).The general information of the four groups of patients were recorded,including: age,gender,duration of diabetes,smoking history,drinking history,height,weight,blood pressure,blood biochemical indicators of all patients,fasting blood glucose(FBG),glycosylated hemoglobin(hemoglobin A1 c,Hb Alc),total triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein(high-density)Lipoprotein cholesterol,HDL-C),fasting C-peptide and 2 hours postprandial C-peptide.Calculate the difference between C-peptide and fasting C-peptide at 2 hours after meal to obtain ?C peptide,detect blood routine RDW-CV,and measure urine microprotein/creatinine.Value(UACR).Compare the clinical indicators between the four groups.The difference between RDW-CV in the four groups.The correlation between RDW-CV and other indicators was analyzed.According to age,disease duration,FBG,?C peptide,TC,TG,LDL-C,SBP,Hb Alc,RDW-CV were independent variables,and whether early DN and DR were dependent variables,the risk factors of early DN and DR were identified.Results: 1.Comparison of four groups of general information and test indicators 1.1 There were no significant differences in general data(age,sex ratio,smoking history,drinking history,BMI,DBP)between the four groups(P>0.05);four groups of indicators(LDL-C,HDL-C,There was no significant difference between DBP and TG)(P>0.05);see Table 1.1.2 Compared with group A,the course of disease,SBP,FBG,TC and Hb Alc were increased in the diabetic microangiopathy group(group B,group C,group D),and the ?C peptide was decreased,the difference was statistically significant(P<0.05);Compared with group A and group C,RDW-CV was increased in group B and group D,the difference was statistically significant(P<0.05).There was no significant difference in RDW-CV between group A and group C(P >0.05);see Table 1.1.3 Compared with group D,the course of disease and SBP were lower in group B and group C,the difference was statistically significant(P<0.05);group D was higher than group C,the difference was statistically significant(P<0.05);Compared with group B,the ?C peptide was lower in group D,and the difference was statistically significant(P<0.05).There was no significant difference in the remaining indicators.See Table 1.2.RDW and other clinical indicators correlation analysis results RDW-CV was positively correlated with FBG,TC,SBP,DBP and Hb A1 c,and negatively correlated with ?C peptide value,and had no significant correlation with other indicators,as shown in Table 2.3.Logistic regression analysis of risk factors for diabetic microangiopathy 3.1 Logistic regression analysis was performed with age,disease course,FBG,?C peptide,TC,TG,LDL-C,SBP,Hb Alc,RDW-CV as independent variables.The results showed that the course of disease,SBP,Hb Alc,TC,RDW-CV were independent risk factors for early diabetic nephropathy,and ?C peptide was a protective factor for early diabetic nephropathy,as shown in Table 3.3.2 Logistic regression analysis was performed for the presence of diabetic retinopathy as the dependent variable,age,duration,FBG,?C peptide,TC,TG,LDL-C,SBP,Hb Alc,RDW-CV.The results showed that the course of disease,SBP and Hb Alc were independent risk factors for diabetic retinopathy,and ?C peptide was a protective factor for diabetic retinopathy.See Table 4.3.3 Logistic regression analysis was performed for whether or not diabetic retinopathy and early diabetic nephropathy were the dependent variables,age,duration,FBG,?C peptide,TC,TG,LDL-C,SBP,Hb Alc,RDW-CV.The results showed that the course of disease,SBP and total cholesterol were independent risk factors for diabetic retinopathy with early diabetic nephropathy.?C peptide was a protective factor for diabetic retinopathy + early diabetic nephropathy,as shown in Table 5.Conclusion: 1.The more disordered sugar and lipid metabolism,the longer the course of disease,the higher the blood pressure,the larger the RDW-CV value and the lower the ?C value,the greater the risk of early diabetic nephropathy.RDW-CV can be used as an independent predictor of early diabetic nephropathy.2.The more disordered glucose metabolism,the longer the course of disease,the higher the blood pressure and the lower the ?C value,the greater the risk of diabetic retinopathy.There was no significant correlation between RDW-CV and diabetic retinopathy.3.The more disordered lipid metabolism,the longer the course of disease,the higher the blood pressure and the lower the ?C value,the greater the risk of diabetic retinopathy with early diabetic nephropathy.There was no significant correlation between RDW-CV and diabetic retinopathy with early diabetic nephropathy.