| Background:As the aging society developing,the change of people’s lifestyle,the incidence of elderly type 2 diabetes mellitus(T2DM)patients with lower extremity arterial disease(LEAD)is increasing in recent years.LEAD is an important cause of diabetic foot and even amputation,which poses a serious threat to the quality of life of diabetic patients.Current known risk factors include hyperglycemia,dyslipidemia,etc,but clinical studies have found that controlling these risk factors does not completely prevent the progression,so there may be other potential risk factors unknown,therefore,finding LEAD new risk factors and active intervention are important to improve the prognosis of patients.Serum uric acid(SUA)has both oxidation and oxidation function,its closely related to metabolic syndrome and an independent risk factor for cardiovascular disease.At present,there are few studies on SUA and elderly type 2 diabetes patients with LEAD,the relationship between the two is not clear.Objective:1.Investigate the prevalence of elderly T2 DM patients with LEAD and explore the characteristics of elderly T2 DM patients with LEAD.2.Research the risk factors of elderly T2 DM patients with LEAD.3.Analysis of the correlation between SUA level and elderly T2 DM patients with LEAD.Methods:This study is a retrospective study,the subjects of study were1,070(male 520,female 550)elderly T2 DM patients(≥65 year-old)admitted to the Endocrinology Department of Suizhou Central Hospital in Hubei Province from June2013 to August 2020,collection of basic information,relevant medical history,biochemical data and the result of measurement of ankle-brachial index.Carry out the following statistical analysis:1.The subjects of study were divided into lower-extremity arterial disease group(LEAD group)and non-lower-extremity arterial disease group(n-LEAD group) according to whether the ankle brachial index≤0.9,T test and chi-square test were used to compare the differences between the two groups in the total patients and different gender groups;2.The subjects of study were divided into hyperuricemia group and non-hyperuricemia group according to whether the SUA≤420μmol/L,The non-hyperuricemia group was further grouped by quartile spacing,from low to high was labeled group 1-4,the hyperuricemia group was labeled group 5,analysis of variance and chi-square test were used to compare the difference of clinical indexes and LEAD prevalence among different SUA groups in different gender patients.3.in the end,logistic stepwise regression analysis was used to analyze the risk factors of LEAD and the correlation between SUA level and LEAD in different gender patients.Results:1.Among 1070 elderly patients with T2 DM,the overall prevalence of LEAD was 45.0%,including 205 males(39.4%),276 females(50.2%);In the overall patients,compared with the n-LEAD group,the age,smoking rate,body mass index,systolic blood pressure,triglyceride,total cholesterol,low density lipoprotein-cholesterol,SUA,course of disease,Hb A1 c were significantly higher in the LEAD group,and the male percentage,high density lipoprotein-cholesterol were significantly lower in the LEAD group,and the difference was statistically significant(P<0.05),while there was no significant statistically difference in diastolic blood pressure,serum creatinine(P>0.05).2.The prevalence of LEAD in different uric acid groups was only different in women patients :47.2%,39.3%,40.2%,48.1%,73.3% in groups 1 to 5,respectively,and the differences among the five groups were statistically significant(P<0.05),comparison of each two groups,the prevalence of group 5 was significantly higher than that of group 1-4,the difference was statistically significant(P<0.05).And the prevalence of male patients group 1 to group 5 was 31.7%,33.7%,37.5%,48.5%,45.5%,respectively,and there was no significant difference between the five groups(P>0.05).3.Logistic stepwise regression analysis showed that in the female patients: age,course of diease,body mass index,triglyceride,Hb A1 c were the risk factor for LEAD,and different levels of SUA had different effects on LEAD: using group 3 as the reference group,the OR(95% confidence interval)of uric acid group and LEAD were2.361(95%CI 1.23-4.54;P=0.010),1.397(95%CI 0.72-2.72;P =0.325),1,1.176(95%CI 0.62-2.22;P =0.618),3.146(95%CI 1.65-6.01;P=0.001).Low uric acid level(≤248μmol/L)and high uric acid level(>420μmol/L)were both associated with a higher risk of LEAD.In male patients: age,course of diease,body mass index,total cholesterol,Hb A1 c,smoking,were the risk factor for LEAD,high density lipoprotein-cholesterol was the protect factor for LEAD,and SUA levels were not associated with LEAD.Conclusion:1.In elderly T2 DM patients,the incidence of LEAD is high,age,course,Hb A1 c,total cholesterol,triglycerides,obesity,smoking history were risk factors for LEAD.2.Logistic regression analysis found that SUA levels had type U relations with LEAD in elderly female T2 DM patients,low uric acid(≤248μmol/L)and high uric acid(>420μmol/L)levels were associated with higher LEAD risk,and not significantly associated with LEAD in elderly male T2 DM patients.Note that the SUA level of the elderly female T2 DM patients should be valued and controlled in clinical work,which may help to delay the development of LEAD. |
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