The Study Of The Relationship Between Skin Noninvasive Advanced Glycation End Products In Screening And Peripheral Vascular Lesions And Peripheral Neuropathy Of Type 2 Diabetes Mellitus

Background:With the development of people life and economy,the incidence of type 2diabetes mellitus(T2DM)and its chronic complications are increasing year by year.Studies showed that the skin advanced glycosylation end products(AGEs)was closely associated with diabetic peripheral vascular lesions and peripheral neuropathy.However there was a lack of researches in our country.In order to reducing high morbidity and disability rates of chronic complications of T2 DM,so it is necessary to develop relevant researches exploring whether skin advanced glycosylation end products can be used as a predictor of T2 DM peripheral vascular lesions and peripheral neuropathy.Objective:To analyze the relationship and the clinical significance of noninvasive detection of advanced glycation end products(AGEs)and early peripheral vascular lesions and peripheral neuropathy of type 2 diabetes mellitus(T2DM).Methods:Collected 91 T2 DM patients who had medical examinations at the community health service centes of hefei from August 2017 to May 2018,including 32 cases with diabetic peripheral vascular lesions,30 cases with diabetic peripheral neuropathy,29 cases pure T2 DM.49 cases of normal control group were selected from the medical centes for healthy people.Blood lipid,fasting blood glucose,glycosylation of hemoglobin,urine ratio of A/C,the ankle brachial-index(ABI)and Skin AGEs were detected at the same time.According to ABI,patients with T2 DM were divided into three groups : group without peripheral vascular lesion,group with mild and moderate peripheral vascular lesion.According to the neurological physical examination score,they were divided into: group without peripheral neuropathy,group with mild peripheral neuropathy,moderate and severe peripheral neuropathy group.Results:In the comparision of pure T2 DM group ?T2DM with complications group and control group,the difference had statistical significance(P < 0.05)in these indicators including age ?circumference?systolic blood pressure?FBG?Hb A1c?skin AGEs.Compared with the control group,skin AGEs were higher in the pure T2 DM group and T2 DM with complications.And comparing the later two groups,skin AGEs were higer in the group of T2 DM with complications than pure T2 DM group.At the same period of age,the level of skin AGEs in T2 DM group were higher than control group,and the difference was statistically significant(P < 0.05).The result of one-way anova showed that the more severe T2 DM with peripheral vascular disease and neuropathy was,the higher the skin AGEs level was,and the difference was statistically significant(P < 0.05).The results of multivariate Logistic regression analysis showed that age(OR=0.88,95%CI(0.79,0.99))?FBG(OR=2.24,95%CI(1.35-3.70))? Hb A1c(OR=0.39,95%CI(0.18-0.84))and skin AGEs(OR=1.27,95%CI(0.18-0.84))were influenced factors of T2 DM with peripheral vascular lesions(P < 0.05).Skin AGEs(OR=1.79,95%C(I 1.18,2.71))was influenced factors of T2 DM with peripheral neuropathy(P < 0.05).According to the receiver-operator characteristics(ROC)screenin for peripheral vascular lesions of T2 DM with skin AGEs,the area under ROC was 0.858(95%CI(0.786,0.930)),the optimal cut-off point value of skin AGEs was 73.05 AU,the sensitivity of diagnosis was 93.8%,and the specificity was 68.8%.Between the T2 DM with peripheral neuropathy and skin AGEs,the area under ROC was 0.858(95%CI(0.782,0.933)),the optimal cut-off point value of skin AGEs was 73.75 AU,the sensitivity was 90.6%,and the specificity was 70.3%.Conclusion:Skin AGEs can be used as a predictor of T2 DM with peripheral vascular disease and neuropathy disease.Noninvasive screening of T2 DM with complications provides a theoretical.