| Objective:Through the comparison of low ABI(ABI≤0.90),normal ABI(1.00≤ABI≤1.40),normal baPWV(baPWV<1800cm/s),and high baPWV(baPWV≥1800cm/s)in clinical biochemical indicators and the incidence of diabetic retinopathy,understanding the influence and significance of ankle brachial index(ABI)and brachial-ankle pulse wave velocity(baPWV)on type 2 diabetic patients with retinopathy,which provides a basis for early prediction of diabetic retinopathy.Methods:206 T2DM patients totally were enrolled during November 2016 till to November 2017,from Endocrinology Department,the Affiliated Hospital of Yan’an University.The basic parameters of the patients including sex,age,duration of diabetes,personal histories and past histories,related clinical data including BMI,FBG,HbA1c,TG,TC,HDL,LDL,the occurrence of T2DM retinopathy disease,etc,were collected and recorded.Using automatic atherosclerosis detector for ABI detection and baPWV detection,according to the data,divided into two groups,65 cases in low ABI group(ABI≤0.90),and 141 cases in the normal ABI(1.00≤ABI≤1.40).The clinical data,the incidence of retinopathy disease and the degree of retinopathy disease between the two groups were compared;According to the data,divided into two groups,normal baPWV(baPWV<1800cm/s)is 128 cases,78 cases with the high baPWV(baPWV≥1800cm/s),the clinical data,the incidence of retinopathy disease and the degree of retinopathy disease between the two groups were compared;The risk factors associated with retinopathy were also analyzed.Result:1.The levels of age,duration of diabetes,BMI,HbA1c,FBG,SBP,DBP,TG,TC,HDL-C,LDL-C between ABI abnormal group and normal group were analyzed by t test,the result shows:the levels of age,duration of diabetes,HbA1c,SBP,TG,TC,LDL-C were difference between the two groups,(P<0.05);No difference was observed in BMI,FBG,DBP,and HDL-C in each group,(P>0.05).Compared with the low ABI group,the age,duration of diabetes,levles of HbA1c,TG,TC and LDL-C were lower in normal ABI group,(P<0.05).2.The sex ratio,smoking history,the incidence of retinopathy disease in the ABI abnormal group and the normal group were compared by theχ2 test,the result shows:The smoking history,and the incidence of retinopathy disease were obviously difference in each group,(P<0.05);No difference was observed in sex in each group,(P>0.05).Compared with the normal ABI group,the smoking history,and the incidence of retinopathy disease were elevated in low ABI group,(P<0.05).3.The levels of age,duration of diabetes,BMI,HbA1c,FBG,SBP,DBP,TG,TC,HDL-C,LDL-C between baPWV abnormal group and normal group were analyzed by t test,the result shows:the levels of age,duration of diabetes,BMI,HbA1c,FBG,SBP,TG,TC,LDL-C were difference between the two groups,(P<0.05);No difference was observed in DBP and HDL-C in each group,(P>0.05).Compared with the high baPWV group,the age,duration of diabetes,BMI,HbA1c,FBG,SBP,TG,TC,LDL-C were lower in normal baPWV group,(P<0.05).4.The sex ratio,smoking history,the incidence of retinopathy disease in the baPWV abnormal group and normal group were compared by theχ2 test,the result shows:The smoking history,and the incidence of retinopathy disease were difference between the two groups,(P<0.05);No difference was observed in sex in each group,(P>0.05).Compared with the normal baPWV group,the smoking history,and the incidence of retinopathy disease were elevated in high baPWV group,(P<0.05).5.Comparison of general clinical data between nondiabetic retinopathy(NDR)and diabetic retinopathy(DR):The levels of age,duration of diabetes,BMI,HbA1c,FBG,SBP,DBP,TG,TC,HDL-C,LDL-C between the two groups were analyzed by t test,the result shows:the duration of diabetes,HbA1c,FBG,SBP,DBP,TG,TC,LDL-C were difference between the two groups,(P<0.05);There was no difference in age,BMI and HDL-C between the two groups,(P>0.05).Compared with the nondiabetic retinopathy group,the duration of diabetes,HbA1c,FBG,SBP,DBP,TG,TC,LDL-C were elevated in diabetic retinopathy group,(P<0.05).The sex ratio,smoking history in the NDR group and DR group were compared by theχ2 test,the result shows:The smoking history was different between the two groups,(P<0.05);No difference was observed in sex between the two groups,(P>0.05);Compared with the NDR group,the smoking history was elevated in DR group,(P<0.05).6.Regarding the occurrence of diabetic retinopathy as a dependent variable,the levels of history of smoking,duration of diabetes,FBG,SBP,DBP,HbA1c,TG,TC,LDL-C,baPWV and ABI were used as independent variables,logistic regression model showed that:(1)the duration of diabetes(OR=2.178,95%CI:1.334~6.505),HbA1c(OR=2.004,95%CI:1.167~5.390),SBP(OR=2.413,95%CI:1.385~7.020),TG(OR=1.816,95%CI:1.123~3.427),TC(OR=1.082,95%CI:1.006~1.208),LDL-C(OR=2.543,95%CI:1.188~5.791),baPWV(OR=1.089,95%CI:1.008~1.215)were positively correlated with the diabetic retinopathy,p<0.05;(2)The DR is negative correlation with ABI,the OR value is 0.925,B=-0.641,P<0.05;(3)The DR was no significant correlation with the smoking history,FBG,and DBP,P>0.05;(4)The duration of diabetes,HbA1c,SBP,TG,TC,LDL-C,baPWV and ABI are the risk factors of diabetic retinopathy.7.In the analysis of the correlation between the degree of retinopathy disease and ABI and baPWV,it shows that DR is negative correlation with the ABI value,r_s=-0.537,p<0.01;The DR is positive correlation with baPWV value,r_s=0.472,p<0.01.The incidence of DRⅠ(30.8%),Ⅱ(21.5%),Ⅲ(15.4%)in ABI abnormal group was higher than that of ABI normal group(Ⅰ:19.9%,Ⅱ:7.1%,Ⅲ:1.4%),P<0.05;The incidence of DRⅠ(32.1%),Ⅱ(14.1%),Ⅲ(19.2%)in baPWV abnormal group was higher than that of baPWV normal group(Ⅰ:17.2%,Ⅱ:5.5%,Ⅲ:3.1%),P<0.05.Conclusion:1.Compared with the normal ABI group,the incidence of retinopathy disease were elevated in low ABI group(ABI≤0.90),P<0.05.2.Compared with the normal baPWV group,the incidence of retinopathy disease were elevated in high baPWV group(baPWV≥1800cm/s),P<0.05.3.Low ABI values are associated with age,smoking history,longer duration,hyperglycemia,hypertension,dyslipidemia.4.High baPWV values correlate with age,smoking history,longer duration,obesity,hyperglycemia,hypertension,dyslipidemia.5.The risk factors for DR are:the duration of diabetes,HbA1c,SBP,TG,TC,LDL-C,baPWV and ABI.6.The use of low ABI and high baPWV as indicators of early screening for retinopathy in patients with type 2 diabetes,which can provide a good indication of the possibility of developing retinopathy,so that we take intervention measures as soon as possible to prevent further damage to our eyesight. |
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