Associated With The Development Of Peripheral Arterial Disease

Backgrounds.As one of the microvascular complications of diabetes mellitus(DM),diabetic retinopathy(DR)becomes the leading cause of blindness in patients with DM.However,peripheral arterial disease(PAD)caused by diabetes is highly prevalent,and severe cases will be confronted with foot ulcers and even amputations.Therefore,both DR and PAD have serious impact on people's quality of life,but the research about the relationship between DR and PAD is rare.There is still lack of consensus on the relationship between DR and PAD in patients with type 2 diabetic mellitus(T2DM).Aims.Indentify the relationship between DR and PAD as assessed by ABI and peripheral arterial plaque and explore the risk factors of DR furtherly in patients with type 2 diabetes mellitus(T2DM)Methods.1421 patients diagnosed with T2DM were recruited in this study.DR was classified as Non-DR,nonproliferative DR(NPDR)and proliferative DR(PDR)stages.Compare the clinical data of the three groups.Explore the relationship between DR and PAD as assessed by ankle-brachial index(ABI)and peripheral arterial plaque.Logistic regression analysis was employed to analyze risk factors associated with DR.Results.Patients with NPDR and PDR had longer Duration of T2DM,higher systolic blood pressure(SBP),total cholesterol and LDL-C than Non-DR group(p<0.05).The prevalence of abnormal ankle-brachial index(ABI)in Non-DR,NPDR,PDR groups was 7.00%,10.80%,and 13.96%,respectively(p<0.05),while the prevalence of peripheral arterial plaque was 68.48%,81.38%,and 80.56%,respectively(p<0.001).Logistic regression analysis showed that DR(vs.non-DR)was closely associated with peripheral arterial plaque(OR=2.07,95%CI:1.48-2.91,P = 0.000),SBP?130 mmHg(OR=1.53,95%CI:1.16-2.02,P = 0.003),HbA1c(OR=2.11,95%CI:1.30-3.42,P = 0.002),TC(OR =1.42,95%CI:0.93-2.18,P = 0.003),and duration of T2DM(OR =1.08,95%CI:1.05-1.10,P =0.000).Conclusion.NPDR and PDR is commonly associated with PAD as assessed by ABI,peripheral arterial plaque.Aditionally,the prevalence of PAD is increasing with the aggravation of DR.Ophthalmologists and physicians all need to pay attention to the relationship between DR and PAD,and to screen for PAD and DR to avoid missed diagnosis.It is inferred that DR was closely associated with macroangiopathy and microangiopathy.To a certain extent,DR can reflect their pathological change.Hyperglycemia?hypertension and dyslipidemia as common risk factors play an important role on the development of macroangiopathy and microangiopathy in patients with T2DM.So,the control of hyperglycemia,hypertension and dyslipidemia early can reduce the prevalence of macroangiopathy and microangiopathy concurrently.