The Correlation Analysis Of Serum Cystatin C And Ventricular Remodeling In Type 2 Diabetic Patients With Metabolic Inflammatory Syndrome

Objective:The purpose of this study was to investigate the correlation between serum cystatin C levels and cardiac structure and function in patients with type 2 diabetes with metabolic inflammatory syndrome,and to provide evidence for early prevention and treatment of ventricular remodeling and heart failure in clinical work.Methods:A total of 144 T2 DM patients who were treated in our endocrinology and metabolism department from January 2019 to June 2019 were collected.124 patients were selected and selected according to the inclusion and exclusion criteria,including69 males and 55 females.The selected population was asked about medical history and basic data collection,and recorded their cystatin C,urea nitrogen,creatinine,uric acid,cholesterol,triglycerides,high-density lipoprotein cholesterol(HDL),low-density lipoprotein cholesterol(LDL),and glycated hemoglobin(HbA1c),fasting C-peptide and other experimental indicators,and query their cardiac color Doppler ultrasound-related results,including left atrial inner diameter(LAD),ventricular septal thickness(IVSTd),left ventricular end-diastolic diameter(LVDd),left ventricle Posterior wall thickness(LVPWTd),left ventricular short-axis shortening rate(FS),left ventricular ejection fraction(EF),E-wave peak flow velocity(E),A-wave peak flow velocity(A),etc.According to the Devereux correction formula and Eichik The formula calculates the left heart mass index(LVMI).All patients were divided into two groups based on serum cystatin C levels.There were 62 cases in the lower level group(0.38 mg / L ? serum cystatin C ? 0.83 mg / L),and the higher level group(0.84 mg / L ? serum Cystatin C?1.56 mg / L)in 62 cases.The relationship between left heart mass index and diastolic function and cystatin C and other metabolic factors was analyzed in all patients.Statistical processing: SPSS 24.0 software was used for statistical processing.The measurement data that conforms to the normal distribution is expressed by the mean standard deviation(),and the data that does not meetthe normal distribution are expressed by the median and interquartile range orpercentage.The independent T test,Mann Whitney U test,or chi-square test were used to analyze the differences in indicators between the groups;the Pearson or Spearman test was used to analyze the correlations between the indicators;the multiple regression analysis was used to analyze the factors affecting the indicators using binary logistic regression.P <0.05 is considered statistically significant.Results:1.In the study population,between different levels of cystatin C group,age,course of disease,number of arterial plaques,systolic blood pressure,creatinine,cholesterol,LDL,LAD,IVSTd,LVDd,LVPWTd,LVMI,E / A was statistically significant.In the high-level cystatin C group,LAD,IVSTd,LVDd,LVPWTd,and LVMI were higher than the low-level group,and E / A was lower than the low-level group.The differences were statistically significant.There was no significant difference in FS and EF between the two groups(P> 0.05).2.The correlation analysis results between LVLVMI and E / A and clinical indicators showed that LVMI was positively correlated with age,IVSTd,LVDd,LVPWTd,A peak,and cystatin C,and negatively correlated with E / A;E / A and E The peaks were positively correlated with age,IVSTd,LVMI,A peak,and cystatin C,but the correlation with cystatin C was weak,with a correlation coefficient of-0.254(P <0.05).3.The multivariate linear regression analysis results of LVMI showed that E / A,cystatin C and LVMI were independently related,and their standardized coefficients were-0.310 and 0.523(P <0.05),of which cystatin C was a risk factor for LVMI.E /A is a protective factor for LVMI.4.Multivariate logistic regression analysis of diastolic function showed that age,LVMI and diastolic function were independently related,and their OR values were1.084 and 1.121(P <0.05),which were independent risk factors for diastolic function.Conclusion:1.There are differences in age,course of disease,number of arterial plaques,systolic blood pressure,creatinine,cholesterol,LDL,LAD,IVSTd,LVDd,LVPWTd,LVMI,and E / A among the different cystatin C levels in this study.Statisticalsignificance.Among the groups with higher levels of cystatin C,compared with the lower group,LAD,IVSTd,LVDd,IVSTd,and LVMI all increased,E / A decreased,and the differences were significant,which may initially suggest that serum cystatin C and myocardial remodeling Relevant.2.In this study,age and Cys c levels were positively correlated with LVMI,and E / A values were negatively correlated with it,suggesting that in elderly patients with type 2 diabetes with MIS,if the level of cystatin C is elevated and there is abnormal diastolic function,then the It is more likely to have left ventricular hypertrophy.After adjusting for age,disease duration,systolic blood pressure,urea nitrogen,creatinine and other related confounding factors,an increase in baseline serum cystatin C levels remains an independent risk factor for increased left ventricular mass index in patients with type 2 diabetes with MIS.3.In this study,age,LVMI and E / A were negatively correlated.Further multivariate logistic regression analysis showed that age and LVMI are independent risk factors for diastolic function,which indicates that with age,left heart The higher the quality index,the greater the risk of diastolic dysfunction.