The Research About Blood Serum MMP-9, VEGF Level And Hemodynamic Alleosis With Peripheral Vascular Disease In Type 2 Diabetes Mellitus

Objective:To investigate the concentration of serum matrix metallproteinase-9(MMP-9),vascular endothelial growth factor(VEGF) levels and to measure hemodynamics index with peripheral vascular disease(PVD) in type 2 diabetes mellitus(T2DM). (1) analyzing the relationship and possible pathogenesy between serum MMP-9,VEGF with peripheral vascular disease in type 2 diabetes mellitus.(2) comparing biphase arteries Doppler ultrasound with lower extremity blood vessel colorized Doppler ultrasound the pristine diagnosis significance of peripheral vascular disease in type 2 diabetes mellitus.Methods:(1)Sample collection:We selected 84 cases from the first affiliated hospital of medical school Shihezi University between February 2010 and August 2010 on basis of the diagnostic criteria and typing of diabetes mellitus in 1999.64 cases were type 2 diabetes mellitus (T2DM),20 cases healthy people were selected as normal controls(NC). Based on lower extremity blood vessel colorized Doppler ultrasound exam results,type 2 diabetes mellitus patients were divided into peripheral vascular disease(PVD) and non-peripheral vascular disease(NPVD).(2)Detection of the samples:serum MMP-9,VEGF were measured by enzyme linked immunosorbent assay, hemodynamics index were measured by biphase arteries Doppler ultrasound.(3)Statistical analysis:The SPSS 17.0 was used for statistical analysis.Continuous variables were presented as mean±sd and difference between two groups were tested using t-test and analysis of variance(ANOVA),to assess the dependability by coefficient of relate/partial correlation and multiple regression analysis. A value of less than 0.05 was considered statistically significant.Results:Fasting blood serum MMP-9:PVD group(349.12±123.76μg/L), NPVD group(281.46±112.99μg/L) were higher than NC group(201.34±77.09μg/L), PVD group was higher than NPVD group too, they were significantly difference (p<0.05).Fasting blood serum VEGF:PVD group(458.95±139.96pg/ml) was higher than NPVD group (354.32±130.47pg/ml) and NC group(268.90±131.37pg/ml), NPVD group was higher than NC group too, they were significantly difference (p<0.05).hemodynamic index:(1)Ankle/Brachial Index(ABI):NC group(1.11±0.04),NPVD group (1.10±0.08),PVD group(1.09±0.13); (2)Toes/Brachial Index(TBI):NC group(0.82±0.04),NPVD group (0.81±0.11),PVD group(0.76±0.10); (3)Pulsatility Index(PI):NC group(6.01±1.39),NPVD group (6.00±2.17),PVD group(4.94±1.88); (4)Mean Velocity(MV):NC group(3.90±1.82cm/s),NPVD group (3.31±2.17cm/s),PVD group(2.75±2.08cm/s); (5)Resistent Index(RI):NC group (0.96±0.02),NPVD group (0.97±0.02),PVD group(0.97±0.03); above index were not significantly difference (p>0.05).The result of correlation analysis:PVD was positively correlated with MMP-9, VEGF, SBP, Age, Course (p<0.05).Measure of Agreement Kappa:The anastomosis level is low that biphase arteries Doppler ultrasound with lower extremity blood vessel colorized Doppler ultrasound. The result of Logistic regression analysis showed that MMP-9, VEGF were risk factors of PVD.Conclusion:(1) MMP-9, VEGF are risk factors of PVD in T2DM,they play an important role in the process of PVD in T2DM. (2) Lower extremity blood vessel colorized Doppler ultrasound is more significance than biphase arteries Doppler ultrasound in pristine PVD of T2DM.