Study On The Relationgship Between The Difference Of Interankle Systolic Blood Pressure And Carotid Atherosclerosis In Patients With Type 2 Diabetes

Objectives:To investigate the relationship between the difference of interankle systolic blood pressure(IAND)and carotid intima-media thickness(CIMT)in patients with type 2 diabetes,to achieve early diagnosis and early intervention of cervical vascular sclerosis in patients with type 2 diabetes;Observing the influence of age,blood lipids,blood glucose,ankle brachial index,pulse wave velocity and other factors on interankle systolic blood pressure.Methods:A total of 295 patients with type 2 diabetes were selected from November 1,2017 to October 30,2018 in the Department of Endocrinology,Second Affiliated Hospital of Kunming Medical University.According to the arteriosclerosis examination of the extremities,the difference of interankle systolic blood pressure(IAND)was calculated,and the subjects were divided into three groups:group A:IAND<5mmHg(n=160);group B:5mmHg≤IAND<10mmHg(n=91);Group C:IAND≥10 mmHg(n=44).Recording general information such as gender,age,body mass index(BMI),and Laboratory indicators such as triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C),uric acid(UA).creatinine(CREA),homocysteine(HCY),fasting Plasma glucose(FPG),2 hours plasma glucose(2hPG),glycosylated hemoglobin(GHB),pulse wave velocity(baPWV),ankle brachial index(ABI).At the same time,the carotid artery ultrasound was performed to measure bilateral carotid intima-media thickness(CIMT)and plaque detection rates.To observe the relationship between the difference of interankle systolic blood pressure and CIMT in patients with type 2 diabetes.Resu ts:(1)Comparison of CIMT values among three groups of subjectsThe CIMT values of group A,group B and group C were respectively(0.85±0.26)mm,(0.96±0.29)mm,and(1.08±0.49)mm.There were differences in CIMT between the three groups,and the differences were statistically significant(p<0.05).(2)Comparison of the detection rates of carotid plaques in three groups of subjectsThe detection rates of plaques in group A,group B and group C were respectively 51.2%,61.5%and 68.2%.There was no significant difference in the detection rate of plaque between group A and group B,group B and group C,group C and group A(p>0.05).(3)Analysis of risk factors for increased the difference of interankle systolic blood pressureThe subjects’ age,gender,BMI,baPWV mean,ABI mean,TC,TG,HDL-C,LDL-G,UA,CREA,HCY,FPG,2hPG,HbAlc,CIMT,plaque detection rate were taken as the independent variable and the difference of interankle systolic blood pressure were used as the dependent variables.Multivariate logistic regression analysis showed that the carotid intima-media thickness was the only risk factor for the increase of blood pressure difference between the daytimes(p<0.05).Carotid intima The greater the thickness of the middle layer,the higher the risk of increasing the intercondylar difference(OR=1.749 in model 1,95%CI:1.035-3.035,p<0.05;OR=2.074 in model 2,95%Cl:1.028-4.186,p<0.05).Conclusions:(1)In patients with type 2 diabetes,the occurrence of carotid atherosclerosis may be related to the difference of interankle systolic blood pressure.After excluding hypertension,which is a risk factors for carotid atherosclerosis,the thicker carotid intima-media thickness is the greater the difference of interankle systolic blood pressure.The difference of blood pressure between the ankles can be used as a simple indicator of atherosclerosis.(2)There is an age difference in I AND.The older the IAND is,the larger the IAND is.IAND is also the same as the inter-arm blood pressure difference(IABPD),and may be used as an intermediate indicator of peripheral vascular disease following the arterial stenosis to predict cardiovascular disease.