Correlation Between Weight And Cardiovascular Risk Factors In Patients With Type 2 Diabetes Mellitus

Objective:As the development of social economy and the change of people's lifestyle,the prevalence of obesity and type 2 diabetes mellitus?T2DM?is increasing.Report on Nutrition and Chronic Diseases of Chinese Residents?2015?^[1]showed that the rate of overweight and obesity in national adult was 30.1%and 11.9%,respectively.The prevalence of diabetes mellitus among adults in China was 10.4%in 2013^[2].Diabetes mellitus,especially T2DM related cardiovascular disease has become the leading cause of death in China,seriously affected the quality of life and life expectancy of patients with T2DM,and brought a heavy economic burden on family and society.This study was aim to explore the correlation between weight and cardiovascular risk factors of type 2 diabetes mellitus,so as to prevent and reduce the occurrence of cardiovascular complications of diabetes mellitus.Methods:1.246 T2DM patients were enrolled in this study from March 2018 to August 2018 in the Endocrinology department of the Third Hospital of Hebei Medical University.Height and weight were measured,and calculated the body mass index?BMI?=weight?kg?/height?m?².246 T2DM patients were divided into three groups according to BMI:normal weight group?18.5kg/m²?BMI?23.9 kg/m²?,overweight group?24.0 kg/m²?BMI?27.9 kg/m²?and obesity group?BMI?28kg/m²?.Normal weight group consisted of 24males and 30 females.Overweight group consisted of 77 males and 43females.Obesity group consisted of 24 males and 30 females.2.General data:Gender,age,the duration of T2DM,personal history?smoking,and drinking?,family history of diabetes mellitus,height and weight were recorded in detail.Systolic blood pressure?SBP?and diastolic blood pressure?DBP?of right upper brachial artery were measured at about 7:00 in the morning.3.Biochemical parameters:Blood samples were collected after overnight fasting,serum were frozen at-20?.Fasting blood glucose?FPG?,triglyceride?TG?,total cholesterol?TC?,high density lipoprotein cholesterol?HDL-C?,low density lipoprotein cholesterol?LDL-C?,blood urea nitrogen?BUN?,serum creatinine?SCr?,serum uric acid?SUA?,fibrinogen?FIB?and hypersensitive c-reactive protein?hs-CRP?were detected.2 hours postprandial blood glucose?2hPBG?was also measured.Glycosylated hemoglobin?HbA1c?and urinary microalbumin/creatinine ratio?UACR?were detected by immunonephelometry?DCA2000?,Germany?.4.Diabetic retinopathy?DR?screening:All of the patients with T2DM were examined by ophthalmoscopy and fundus color photography in the ophthalmology department to diagnosis of DR.5.Statistical analysis:Statistical analysis was performed by SPSS software?version 23.0,SPSS Inc.,Chicago?.Normality data were presented as mean±standard deviation??X±SD?,non-normality data were presented as median?interquartile range?.Student's t-tests,ANOVA,the chi-square test??²test?,Kruskal-Wallis Test,the Pearson correlation analysis and Spearman rank correlation analysis were performed.P value less than 0.05 was considered statistically significant.Results:1.Comparison of Clinical and biochemical characteristics.?Fig 1,Table1?Accompany with weight gain,hs-CRP and DBP increased gradually.There were significant differences in SBP,TG,HDL-C,SUA,2hPBG,gender and age among three groups.TG and SUA were higher in overweight group than those in normal weight group,whereas HDL-C was lower in overweight group than that in normal weight group.SBP,2hPBG,TG,SUA were higher in obesity group than those in normal weight group,while HDL-C and age were lower in obesity group than those in normal weight group.The proportion of male in obesity group was higher than that of normal weight group.Compared with overweight group,SBP and 2hPBG was increased,while HDL-C was decreased and age was younger in obesity group.?P<0.05?There was no significant difference in TC,LDL-C,HbA1c,UACR,FPG,BUN,SCr,FIB,cigarette smoking history,drinking history,family history and DR among three groups?P>0.05?.2.Correlation between BMI and clinical and biochemical characteristics.?Table 2?BMI was positively correlated with SBP?r=0.360,P=0.000?,DBP?r=0.527,P=0.000?,TC?r=0.141,P=0.027?,TG?r=0.158,P=0.013?,LDL-C?r=0.178,P=0.005?,hs-CRP?r=0.337,P=0.000?,SUA?r=0.253,P=0.000?and 2hPBG?r=0.260,P=0.000?,whereas negatively correlated with HDL-C?r=-0.250,P=0.000?,age?r=-0.224,P=0.000?and the duration of T2DM?r=-0.129,P=0.043?.BMI correlated with male,cigarette smoking and drinking history.There was no significant correlation between BMI and HbA1c,UACR,FPG,BUN,SCr,FIB,family history and DR?P>0.05?.Conclusions:1.In patients with type 2 diabetes mellitus,weight is correlated with blood pressure,blood lipid,2 hours postprandial blood glucose,serum uric acid and inflammatory factors;2.With body mass index increasing,blood pressure trends to increase;3.Overweight/obesity patients with type 2 diabetes mellitus are in a state of chronic inflammation.