Relationship Between Urinary Albumin To Creatinine Ratio And Lower Extremity Arterial Disease In Patients With Type 2 Diabetes Mellitus

Objective To study the relationship between urinary albumin to creatinine ratio(UACR)and lower extremity arterial disease(LEAD)in type 2 diabetic patients,and to explore the related factors of lower extremity arterial disease in type 2 diabetic,which is helpful for early clinical prevention and intervention of chronic diabetic vascular complications.Method From June 2016 to January 2019,577 patients with type 2 diabetes mellitus(T2DM)in Department of Endocrinology,Anhui Provincial Hospital were selected.The sex,age,height,weight,smoking history,blood pressure at admission and laboratory related clinical data were collected.According to the results of ABI(ABI≤0.90,diagnosis of diabetic lower extremity arterial disease),the patients were divided into lower extremity arterial disease group(LEAD group,ABI≤0.90)and not-lower extremity arterial disease group(N-LEAD group,ABI >0.9).According to UACR,the patients were divided into three groups: group I: normal proteinuria(UACR < 30 mg /g Cr),group II: microalbuminuria(30mg /g Cr≤UACR<300mg/g Cr),Group III: a lot of proteinuria(UACR ≥300mg / g Cr).Result1.In this study,a total of 577 patients with type 2 diabetes were selected,of which 105 were in the LEAD group,472 were in the N-LEAD group,and the incidence of lower extremity arterial disease(LEAD)in type 2 diabetes was about 18.2%.The incidence of LEAD in group I was 11.57%(39/337),the incidence of LEAD in group II was27.11%(45/166),and the incidence of LEAD in group III was28.38%(21/74).Differences between the three groups were statistically significant(P<0.05).2.Compared with the N-LEAD group,the age,course of disease,smoking rate,systolic blood pressure(SBP),low-density lipoprotein cholesterol(LDL-C),serum uric acid(UA),serum creatinine(s Cr)and urinary albumin to creatinine ratio(UACR)in LEAD group were higher than those in the N-LEAD group,and the glomerular filtration rate(e GFR)was lower than that in the N-LEAD group,The differences were statistically significant(P < 0.05);Whereas diastolic blood pressure(DBP),body mass index(BMI),glycosylated hemoglobin A1c(Hb A1c),fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG)and high-density lipoprotein cholesterol(HDL-C)were not statistically significant between two groups(P>0.05).3.The Spearman correlation analysis showed that UACR was positively correlated with SBP,Hb A1 c,s Cr,serum UA,age and course of disease,and negatively correlated with e GFR and ABI.The binary multivariate unconditioned Logistic regression analysis showed that the risk factors of T2 DM lower extremity arterial disease were age,course length,smoking history,SBP,LDL-C,serum UA and UACR(P<0.05,OR values were3.693、2.460、1.825、1.785、3.756、1.988、2.380).Conclusion1.This study shows that the ABI was decreased with the increase of UACR,which suggested that the increase of urinary albumin excretion can indicate the the risk oflower extremity arterial disease development.2.Increased age,smoking history,duration of disease,hypertension(especially elevated systolic blood pressure),hyperuric acid,hyperlipidemia and urinary protein excretion were all independent risk factors for lower extremity arterial disease in type 2diabetes mellitus.