The Correlation Analysis Between TBI And UACR In Patients With Type2Diabetes Mellitus

Objective：①To explore the clinical relevant factors of urinary albumin to creatinine ratio and toe branchial index（TBI） in patients with type2diabetesmellitus.②To explore the The correlation between TBI and urinary albumin to creatinine ratio (UACR) in patients with type2diabetes mellitus.Methods：167patients with type2diabetes mellitus (T2DM) were determined by urinary albumin and urine creatinine values and calculated urinary albumin to creatinine ratio（UACR） were enrolled. The patients were divided intonormal albuminuria group (NAU), microalbuminuria group(MiAU) and macrolalbuminuria group(MaAU) by UACR. The patients were also divided into groupof normal and abnormal TBI by TBI. Hemoglobin A1c (HbA1c), cholesterol(CHO), triglyceride(TG), high density lipoproteins cholesterol (HDL-C), low density lipoprotein cholesterol(LDL-C), height, weight, systolic blood pressure(SBP), ankle brachial index(ABI), TBI were measured. Body mass index(BMI) were calculated.The SPSS13.0was used for the statistical analysis. Descriptive data according with normally distributed continuous variables were expressed as mean±SD，while non-normally distributed variables were expressed as median (P25,P75). Normally distributed continuous variables were analysed after converted bythe natural logarithm. The Independent-Samples T Test was used to compare two Independent Samples and the One-Way ANOVA was used to compare multi-sample. Enumeration datas were expressed as cases and constituent ratio,whichwere test by The chi-Square test. Pearson Correlations was used to analysis the relation of ankle brachial index(ABI). The association of UACR/TBI and other factors was test by stepwise multiple regression analysis.Results：①t hecomparison of clinical parameters between NAU, MiAU, andMaAU：course, CHO, TG, LDL-C, HbA1c, proportion of patients with a history of hypertension showed an increasing trend, while HDL-C showed a decreasing trend；abnormal proteinuria group had a higher BMI than normal albuminuria；the comparison of ABI among the three groups, ABI was1.17±0.01vs1. 04±0.01vs0.88±0.02, showed a decreasing trend; TBI values were compared among three groups:0.92±0.01vs0.70±0.01vs0.51±0.01, showeda decreasing trend; All differences between groups were statistically significant(P<0.01).②The comparison of clinical parameters between normal and abnormal TBI: course, BMI, LDL-C, HbA1c, SBP, proportion of patients with a history of hypertension, proportion of patients with a history of smoking showed andecreasing trend, HDL-C was increasing; the comparison of UACR betweenthe two groups:17.75(6.32,37.35) vs323.18(218.79,600.70); all the differences were statistically significant (P <0.01or0.05).③The pearson correlationanalysis of ABI and TBI showed that ABI and TBI were positive linear correlation (r=0.54, P <0.05).④Using UACR as dependent variable, course, BMI,CHO, TG, HDL-C, LDL-C, HbA1c, proportion of patients with a history of hypertension as independent variables, the data was analysed by stepwise multiple regression analysis and showed: with BMI, HbA1c positively correlation (P<0.01), with ABI negative correlation (r=-2.246, P <0.01), with TBI negativecorrelation (r=-1.367, P <0.01).⑤Using TBI as the dependent variable, duration, BMI, HDL-C, LDL-C, HbA1c, SBP, the proportion of patients with a history of hypertension, the proportion of patients with a history of smoking asindependent variable, stepwise multiple linear regression analysis of the data showed that: with BMI, HbA1c negative correlation (P <0.05), with UACR negative correlation (r=-0.05, P <0.01).Conclusions：①The relation of course, CHO, TG, LDL-C, HbA1c, HDL-C,history of hypertension and UACR ratio was close: which showed an increasing trend in NAU, MiAU, MaAU comparison of the three groups, while HDL-C is a decreasing trend，including glycosylated hemoglobin, BMI positively correlated with UACR.②course, BMI, LDL-C, HbA1c, SBP, the proportion ofpatients with a history of hypertension, proportion of patients with a history ofsmoking were closely related with TBI: compared with normal group, abnormal duration, BMI, LDL-C, HbA1c, SBP, the proportion of patients with a history of hypertension, the proportion of patients with a history smoked were increased HDL-C was reduced; including BMI, HbA1c negatively correlated withTBI.