Clinical Characteristics And Influencing Factors Of Diabetes Mellitus Complicated With Lower Extremity Venous Disease

Objective:This study is to clarify the clinical characteristics and influencing factors of diabetic patients with lower extremity venous disease,and aims to provide a reference for scientific identification and prevention of lower extremity venous disease in diabetic patients.Methods:（1）From January 2015 to November 2021,707 patients who were diagnosed with diabetes and underwent color doppler ultrasound of lower extremity veins in the Department of Secretion metabolism and Vascular Surgery of the First Hospital of Jilin University,were retrospectively collected.According to the results of color doppler ultrasound of the lower extremity vein,the patients were divided into three groups: simple diabetes group,diabetic lower extremity vein chronic insufficiency group,and diabetic lower extremity deep vein thrombosis group.（2）General data and clinical indicators of patients were collected.Their general information includes age,sex,BMI,history of hypertension,coronary heart disease,cerebrovascular disease,diabetes course,hypoglycemic method,peripheral arterial disease,etc.The clinical indicators are as follows: blood routine indicators,coagulation function indicators,liver function indicators,lipid metabolism indicators,glucose metabolism indicators,lower extremity vein color ultrasound,etc.（3）SPSS23.0 software was used for data analysis.Indicators with P<0.05 in single-factor analysis were included in multi-factor Logistic regression analysis.Where Forward was used,the LR method was used for variable selection as a way to complete the analysis of influencing factors,with P < 0.05 indicating statistical significance.Results:（1）Among the 707 patients,203 had chronic venous disease of the diabetic lower extremity,205 had deep venous thrombosis of diabetic lower extremities,and 299 had simple diabetes.（2）Among the patients with diabetic lower extremity chronic venous disease,55 cases（27.09%）occurred in the left lower extremity,60 cases（29.56%）were in the right lower extremity,and 88 cases（43.34%）involved bilateral extremities.Superficial thrombophlebitis occurred in 47 cases（23.15%）.There were 65 cases（32.02%）with siltation dermatitis.88.18%（179/203）of the patients showed symptoms and signs,of which the lower extremity weakness and heavy feeling were the most.Furthermore,Binary Logistic regression analysis results showed that age,BMI,NLR,and presence of peripheral arterial disease were positively associated with the risk of chronic venous disease of the lower extremities in combination with diabetes mellitus.Platelet count,activated partial thromboplastin time,and prothrombin time were negatively associated with the risk of chronic venous disease of the lower extremities in combination with diabetes mellitus.（3）Among patients with diabetes mellitus complicated with deep vein thrombosis of lower extremities,86 cases（41.95%）occurred in the left lower limb,76 cases（37.07%）in the right lower limb,and 43 cases（20.98%）involved bilateral limb.91.21%（187 / 205）of patients developed symptoms and signs,with lower limb pain and swelling predominating.Locationspecific involvement rates varied: 20.68% in the calf intermuscular vein,13.74% in the shallow femoral vein,13.29% in the popliteal vein,12.7% in the peroneal vein,12.41% in the posterior tibia,10.49% in the general femoral vein,6.06% in the deep femoral vein,5.76% in the external iliac vein,and 4.87% in the general iliac vein.Binary logistic regression analysis showed that age,body mass index,history of coronary heart disease,history of cerebrovascular disease,combined peripheral artery disease,glycohemoglobin,neutrophils lymphocyte ratio and fibrinogen were positively associated with the risk of diabetes mellitus combined with deep vein thrombosis in the lower extremities.Conclusion:（1）Patients with diabetes mellitus and chronic venous diseases of the lower extremities were often bilateral,and patients might have multiple clinical manifestations,mainly weakness and heaviness of the limbs.（2）Patients with diabetes mellitus complicated by deep vein thrombosis of the lower extremities,the left side of the limb,the calf muscle vein mainly involved,patients might have a variety of clinical manifestations,mainly limb pain,swelling.（3）Analysis of influencing factors in this study showed a positive association between age,body mass index,neutrophils ratio and risk of diabetes associated with chronic venous disease of the lower extremities.Platelet count,time of activation of partial thrombin and time of thrombin were negatively associated with the risk of diabetes associated with chronic venous disease of the lower extremities.（4）The analysis of influencing factors in this study showed a positive association between age,body mass index,history of coronary heart disease,history of cerebrovascular disease,combined peripheral artery disease,glycated hemoglobin,neutrophils lymphocyte ratio and fibrinogen and risk of diabetes mellitus combined with deep vein thrombosis in the lower extremities.