The Study On VWF In Patients Of T2DM Complicated With Hypertension And Analysis Of Correlative Factors

Objective:Type 2 diabetes mellitus(T2DM)and essensial hypertension(EH)are closely related in etiology and either of them could induce arteriosclerosis and cardiac-cerebral vascular disease.An increasing plasma vWF is accepted as a marker of impaired endothelium and golden standard to evaluate endothelium dysfunction. The aim of this study is to compare vWF in the following four groups,including normal controled group(NC),T2DM group,EH group,T2DM complicated with EH(T2DM+EH)group and the correlative factors.We try to provide new evidence and management guideline for preventing and curing the impaired endothelium in T2DM complicated with EH.Method:1.All the subjects(including NC group:30;T2DM group:41;EH group:36; T2DM+EH group:38)were taken history,checking-up,blood pressure(BP)and blood sample.2.Plasma vWF percentage content was measured by enzyme linked immunosorbent assay(ELISA).3.In order to study the effect of blood glucose and BP level to vWF level,we combined group T2DM and T2DM+EH by the standard of HbA₁C≥8%,this new group was divided into four groups,including well-controled T2DM,T2DM+EH and poorly-controled T2DM,T2DM+EH.We also combined group EH and T2DM+EH by the standard of SBP≥160mmHg and(or)DBP≥100mmHg,the new group was also devided into four groups,including mild EH and T2DM+EH and moderate-severe EH and T2DM+EH.4.The data was analyzed in qualitation and quantitation by SPSS11.5 statistical Quantitative data was checked in normal distribution by means of Kolmogorov-Smirnov single factor test;Homoscedasticity was checked by Levene test;Comparison of mean in multigroup were tested by single factor ANOVA; Comparison of every two mean in multigroup were undertaken by SNK-q test.The relationship between vWF percentage content and relative factors was analyzed by Pearson correlation analysis.Different were considered statiscally significant at P＜0.05.Result:1.vWF percentage content in group T2DM,EH and T2DM+EH were higher than NC group;vWF percentage content in group T2DM+EH was higher than group T2DM,EH.(the data was:NC:92.29±23.97 T2DM:115.81±38.56 EH:112.97±32.47 EH+T2DM:133.77±42.75).The variance possessed statistical significance. (P＜0.05)%.2.vWF percentage content in group glucose poorly-controlled T2DM+EH(145.01±33.99)%was highest among well-controled T2DM(106.84±40.56) %,T2DM+EH(114.70±35.12)%and poorly-controled T2DM(112.36±28.19) %.The variance possessed statistical significance.(P＜0.05)3.vWF percentage content in group moderate-severe T2DM+EH(143.36±45.84) %is higher than mild EH(93.50±13.95)%and T2DM+EH(116.83±37.10) %.The variance possessed statistical significance.(P＜0.05)4.vWF percentage content in group NC showed positive correlation with age(r= 0.363,P＜0.05),BMI(r=0.405,P＜0.05);vWF percentage content in groupT2DM showed positive correlation with FIN(r=0.331,P＜0.05),HOMA-IR(r=0.339,P＜0.05),HbA₁C(r=0.385,P＜0.05);vWF percentage content in group EH showed positive correlation with SBP(r=0.430,P＜0.01),PP(r=0.344,P＜0.05),HOMA-IR(r=0.332,P＜0.05);vWF percentage content in groupT2DM+EH showed positive correlation with age(r=0.334,P＜0.05),SBP(r=0.407,P＜0.05),DBP(r=0.354,P＜0.05),HbA₁C(r=0.344, P＜0.05).5.BMI of group NC,FIN,HbA₁C of group T2DM,SBP of group EH,SBP,HbA₁C of group T2DM+EH went into multivariant stepwise regression analysis equations that were independent correlative factor which affected plasma vWF percentage content.Conclusion:1.There is endothelium dysfunction in T2DM patients.The more severe insulin resistance,the worse-controled glucose,the more severe is endothelium impairment.There is endothelium dysfunction in EH patients.The higher SBP and PP,the more severe is endothelium impairment.2.Endothelium dysfunction in T2DM+ EH patients are the most severe among the whole groups.Elder age,higher BP,worse-controled glucose,more severe is endothelium impairment.3.Age,BMI of group NC are positive correlation with endothelium impairment.4.BMI of group NC,FIN,HbA₁C of group T2DM,SBP of group EH,SBP,HbA₁C of group T2DM+EH are independent correlative factor that affected plasma vWF percentage content.