| Objective: To provide a theoretical basis for the clinical use of measuring patients' brachial ankle pulse wave velocity for predicting and screening patients for diabetic retinopathy by studying the correlation between retinopathy and arm-ankle pulse wave conduction velocity in type 2 diabetic patients.Methods:1.One hundred and seventy-four patients with type 2 diabetes mellitus who were admitted to the Department of Endocrinology of Clinical Medical College of Yangzhou University from June 2019 to December 2020 were selected for enrollment.Patients included in the study were required to meet the 1999 WHO diagnostic criteria for diabetes mellitus and the 2002 international clinical classification criteria for diabetic retinopathy.Patients with non-diabetic eye disease;other types of diabetes than type 2 diabetes;acute complications of diabetes: diabetic ketosis and ketoacidosis,hyperglycaemic hypertonic syndrome,hypoglycaemia,diabetic lactic acidosis,etc.;patients with deep vein thrombosis with inferior vena cava filters or suspected thrombosis in the lower limbs;history of lower limb vascular and bone surgery;severe liver,kidney,cardiac disease;with malignancy;ankle-brachial index <0.9 or >1.3.2.General data were collected from 174 patients,and blood was collected to determine glycated hemoglobin(Hb A1c),white blood cell count(WBC),monocyte count,triglycerides(TG),total cholesterol(CHO),HDL-C-C,low-density lipoprotein cholesterol(LDL),blood creatinine(Cr),blood uric acid(UA),blood urea nitrogen(BUN),Hb A1 c,and urine microalbumin(UMA).And fundus photographs were obtained using a fundus disposable imaging machine,and baPWV was measured using an automatic atherosclerosis detector.Patients were divided into NDR and DR groups according to the ophthalmology report results,and the indexes of the two groups were compared using independent sample t-test and chi-square test,and the correlation between baPWV and each clinical index was analyzed using Spearman correlation analysis.Using baPWV as the dependent variable and age,BMI,pulse pressure,UMA,Hb A1 c,MHR,CHO,TG,history of smoking,history of alcohol consumption,history of hypertension,history of stroke,and duration of diabetes as independent variables,binary logistic regression analysis was performed to observe whether each index was correlated with baPWV.Results:1.The mean baPWV values of all patients in both groups were greater than the cut point of 1400 cm/s.The baPWV of the DR group(1715.51±274.10)was significantly higher than that of the NDR group(1503.98±238.17),which was statistically different(P=0.00<0.01).cr,UMA,Hb A1 c,duration of DM,and history of stroke between groups P < 0.05 was statistically significant for comparison.2.Spearman correlation analysis between baPWV and various clinical and biochemical indicators showed that UMA(r=0.163,P<0.05),monocyte(r=0.170,P<0.05),pulse pressure(r=0.170,P<0.05),Cr(r=0.226,P<0.01),duration of DM(r=0.247,P< 0.01)showed positive correlation with baPWV.3,Binary logistic regression analysis,with presence of DR as the dependent variable and UMA,Hb A1 c,age at DM disease duration,BMI,pulse pressure,MHR,CHO,history of smoking,history of alcohol consumption,history of hypertension,history of stroke,and baPWV as independent variables,showed that UMA(OR=1.003,95% CI 1.000 to 1.006,P< 0.05),Hb A1c(OR=1.003,95% CI1.000?1.006,P<0.05),duration of DM(OR=1.121,95% CI 1.028?1.221,P< 0.01),and baPWV(OR=1.003,95% CI 1.002?1.005,P< 0.01)were risk factors for DR.4.The area under the subject operating characteristic curve(ROC)curve for DR patients with baPWV was 0.727,and when the patient's baPWV was 1636,the sensitivity was 62.4% and the specificity was 80%,which had some diagnostic value.Conclusion: The value of baPWV showed positive correlation with UMA,monocyte,Cr,duration of DM disease,and pulse pressure.The occurrence of DR was positively correlated with UMA,baPWV,duration of DM disease,and Hb A1 c,suggesting that baPWV could be one of the risk indicators for the occurrence of DR. |
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