Study On The Correlation Between Waist-to-height Ratio And Homocysteine And Chronic Complications In Patients With Type 2 Diabetes Mellitus

Objective: To explore the correlation between Waist-to-height ratio(WHt R)and homocysteine(Hcy)in patients with type 2 diabetes mellitus(T2DM)and different chronic complications of T2 DM,so as to provide reliable reference for early diagnosis and prevention of chronic complications of T2 DM.Method: From October 1,2021 to November 30,2022,a total of 206 patients with T2 DM were admitted to the General Medicine Department of Yangzhou University Hospital.Collect the general clinical information of the subjects: age,course of disease,WHt R,body mass index,systolic blood pressure,diastolic blood pressure,heart rate,and the data of clinical biochemical indexes: white blood cell count,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A1,apolipoprotein B,apolipoprotein B/A1,lipoprotein(A),Hcy,glycosylated hemoglobin,etc.According to whether have chronic complications of T2 DM or not,the subjects were divided into a simple T2 DM group(43 cases)and a T2 DM combined with chronic complications group(163 cases).According to the combination of different types of chronic complications,the T2 DM combined with chronic complications group was further divided into a macroangiopathy group(55cases),a microangiopathy group(50 cases)and a neuropathy group(58 cases).A simple T2 DM group was used as the control group,and SPSS 25.0 statistical software was used to compare and analyze the clinical data in each group,to explore the differences of WHt R,Hcy and other risk factors in the population combined with different chronic complications,and to draw the ROC curve to analyze the predictive value of WHt R,Hcy and the combination of WHt R and Hcy for the risk of T2 DM patients complicated with chronic complications.Result:1.Compared with the simple T2 DM group,the age,course of disease,WHt R,Hcy and BMI levels in the T2 DM combined with chronic complications group were higher,and the data showed statistical differences(P < 0.05);2.The WHt R of the macroangiopathy group,the microangiopathy group and the neuropathy group was compared with that of the simple T2 DM group,respectively,and the differences were statistically significant(P < 0.05).The Hcy of the macroangiopathy group,the microangiopathy group and the neuropathy group was compared with that of the simple T2 DM group,and the data of the macroangiopathy group were not statistically different(P>0.05),while the data of the microangiopathy group and the neuropathy group were statistically different(P < 0.05);3.Logistic regression analysis showed that WHt R,Hcy and the combination of WHt R and Hcy had a positive correlation with the occurrence of chronic complications of T2DM;4.ROC curve was drawn: The area under the curve corresponding to WHt R was0.641(95% CI: 0.550–0.732,P<0.05),the optimal boundary point was 0.578,and the corresponding Jordan index was 0.282.Under this condition,the prediction sensitivity and specificity were 49.1% and 79.1%,respectively.The area under the curve corresponding to Hcy was 0.611(95% CI: 0.521–0.701,P<0.05),the optimal boundary point was 12.55μmol/L,and the corresponding Jordan index was 0.201.Under these conditions,the prediction sensitivity and specificity were 29.4% and 90.7%,respectively.The area under the curve corresponding to WHt R combined with Hcy was0.675(95% CI: 0.586–0.764,P<0.01),the optimal boundary point was 0.751,and the corresponding Jordan index was 0.280.Under this condition,the prediction sensitivity and specificity were 69.9% and 58.1%,respectively.Conclusion:1.The occurrence of chronic complications in T2 DM patients is closely related to age,course of disease,BMI,WHt R and Hcy level.High WHt R value is related to the occurrence of macroangiopathy,microangiopathy and neuropathy in T2 DM patients.The increase of Hcy level is related to the occurrence of microangiopathy and neuropathy in T2 DM patients;2.The increased WHt R and increased Hcy level are the risk factors for the complicated chronic complications in T2 DM patients.Measuring WHt R and detecting Hcy level in T2 DM patients can effectively predict the risk of complicated chronic complications.The combination of WHTR and Hcy has higher value in predicting the risk of chronic complications in T2 DM.