| Objective To study the indexes of RDW-SD,RDW-CV,MCV,serum IL-10 and IL-19 in patients with T2DM without and with microvascular complications,so as to further understand the mechanism of microvascular complications in T2DM and research auxiliary diagnostic indexes.Methods 129 patients with T2DM and undiagnosed microvascular complications in the Department of Endocrinology,affiliated Hospital of Inner Mongolia Medical University were selected as group A.The patients with T2DM and diagnosed microvascular complications(DR or DN)were selected into group B,a total of 138.After T2DM underwent fluorescein angiography and/or optical coherence tomography,according to the international clinical classification of diabetic retinopathy(2002),the patients with DR in left,right or both eyes,and/or according to the diagnostic criteria of Chinese Diabetic guidelines for Diabetic Nephropathy(2017),the patients who were diagnosed as DN,make up the group B.The serum IL-10 and IL-19 of the above patients were measured by ELISA method,and the clinical data of RDW-SD,RDW-CV and MCV were collected.The above indexes and other clinical indexes were compared between group A and group B,and the risk factors and auxiliary diagnostic indexes of microvascular lesions were analyzed to investigate whether the above indexes can provide evidence for the occurrence of T2DM microvascular complications.Results 1)history of hypertension,Cr,Urea,Tch,120 min PG,HbA1c,UACR,UTP/24 h,RBC,RDW-SD,RDWCV,MCV,WBC,NEUT and serum IL-19 levels in T2DM with microangiopathy group were higher than those in the group without microangiopathy,while HOMA-β(CP),120 min CP,eGFR and serum IL-10 were lower than those in the group without microangiopathy(p<0.05).2)RDW-SD,RDW-CV and MCV were positively correlated with age,course of disease,RBC,WBC,NEUT,UACR and UTP/24h(p<0.05),but negatively correlated with eGFR(p<0.05).IL-10 was negatively correlated with age,MCV,IL-19,HbA1c,FPG,UACR and UTP/24h(p<0.05),but positively correlated with HOMA-β(CP)(p<0.05).IL-19 was positively correlated with RDW-SD and UACR(p<0.05),and negatively correlated with IL-10(p<0.05).There was a positive correlation between RDW-SD and IL-19(p<0.05).RDW-CV was positively correlated with 120 min PG and negatively correlated with FCP and120 min CP(p<0.05).Multivariate Logistic regression analysis indicated that RDW-SD(OR=1.38,p < 0.05),RDW-CV(OR= 1.467,p < 0.01),MCV(OR=1.061,p < 0.05)and serum IL-10(OR=0.971,p < 0.05)were the influencing factors of microvascular complications.3)ROC analysis showed that RDW-SD(AUC=0.805,p<0.01),RDW-CV(AUC=0.819,p<0.01),MCV(AUC=0.85,p<0.01)and IL-10(AUC=0.577,p<0.01)were good predictors of T2DM microvascular complications.Conclusion 1)Erythrocyte parameters(RDW-SD,RDW-CV,MCV)are increased in patients with T2DM complicated with microangiopathy.RDW-SD,RDW-CV and MCV can be used as auxiliary indexes in the diagnosis of microangiopathy.2)After the progression of microangiopathy,IL-10 decreased,and IL-10 can be used as an auxiliary index for the diagnosis of microvascular complications.The level of IL-19 mediates inflammation and angiogenesis.When T2DM is complicated with microangiopathy,the level of IL-19 increases.3)Red blood cell parameters,IL-10 and IL-19 are not only separately involved in the occurrence and development of T2DM microvascular lesions,but also influence each other.Red blood cell parameters,IL-10 and IL-19 together with course of disease,islet dysfunction and blood glucose level involved in the occurrence and development of microvascular lesions. |
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