Analysis Of Clinical Features And Risk Factors Of Type 2 Diabetes Mellitus Complicated With Interstitial Lung Disease

Objective:Through the retrospective analysis of patients with type 2 diabetes mellitus（T2DM）complicated with interstitial lung disease（ILD）,we can understand the clinical characteristics and general laws of T2 DM complicated with ILD,analyze its risk factors,improve the understanding of T2 DM complicated with ILD,and improve the reasonable management of ILD in clinic,which can help improve the quality of life and survival cycle of patients.Methods:The collected clinical data were analyzed by spss25 0 statistical software for analysis.Methods from January 2016 to October 2021,52 patients with type 2diabetes mellitus complicated with interstitial lung disease diagnosed at the second hospital of Jilin University were selected.In the study group（group T2DM-ILD）;50patients with simple type 2 diabetes mellitus（without severe heart and kidney abnormalities）were randomly selected as simple T2 DM group;And 50 patients without simple cause interstitial lung disease were randomly selected as simple ILD group.The basic data,basic diseases,clinical characteristics,laboratory examination and other clinical data of T2DM-ILD group were compared with patients in simple T2 DM group and simple unexplained ILD group respectively.The statistically significant risk factors were analyzed by univariate analysis as independent variables,and the risk factors of T2 DM complicated with ILD were explored by multivariate logistic regression analysis;The indexes with clinical diagnostic or predictive value were analyzed by sensitivity curve（ROC）,P<0.05,indicating a statistical difference.Results:1、Comparison of the basic dataTotal of 52 patients in T2DM-ILD group were included with an average age of66.25 ± 8.60 years,including 24 males（46.2%）and 28 females（53.8%）;There were 50 patients with an average age of 63.32 ± 12.42 years in T2 DM group,including 27 males（54.0%）and 23 females（46.0%）;There were 50 patients with an average age of 63.06 ± 9.03 years in the simple ILD group,including 24 males（48.0%）and 26 females（52.0%）;T2dm-ild group was compared with simple T2 DM group and simple ILD group respectively.It was found that there was no significant difference in gender composition,age distribution,smoking,drinking and BMI（P>0.05）.2、Comparison of basic diseases and clinical symptomsThe cases of fatty liver in ILD-T2 DM group were higher than those in T2 DM group（P<0.05）;There was no significant difference between the two groups in the history of hypertension,ischemic heart disease,reflux esophagitis,cerebrovascular disease and thyroid disease（P>0.05）.Compared with simple ILD group,ILD-T2 DM group was more prone to dyspnea and fever in patients with T2 DM complicated with ILD.The difference between the two groups was statistically significant（P<0.05）.In Fatty liver,reflux esophagitis history was significantly higher than simple ILD group;There was no significant difference in the history of cough,sputum,chest pain,hypertension,coronary artery disease,cerebrovascular disease and thyroid disease between the two groups（P>0.05）.3、Comparison of methods of blood glucose control and duration of type 2diabetes mellitusCompared with the simple T2 DM group,the T2DM-ILD group was significantly higher in the T2DM-ILD group than in the T2 DM group,and the difference was statistically significant（P<0.05）.However,there was no significant difference between the two groups in the way of blood glucose control（diet or exercise,oral hypoglycemic drugs alone,insulin alone,hypoglycemic drugs combined with insulin）（P>0.05）.4、Comparison of laboratory examination indexesThe levels of prothrombin time,fibrinogen,high-sensitivity CRP,ESR,FBG and Hb A1 c in T2DM-ILD group were significantly higher than those in T2 DM group（P<0.05）;At the same time,it was found that the level of albumin in T2DM-ILD group was significantly lower than that in simple T2 DM group（P<0.05）;There was no significant difference in leukocyte count,partial prothrombin time,D-dimer,neutrophil count,lymphocyte count,platelet count,hemoglobin,procalcitonin,ferritin,serum creatinine,uric acid,urinary glucose,urinary protein and urinary ketone body（P>0.05）.Compared with simple ILD group,the levels of fibrinogen,high-sensitivity CRP,ESR,ferritin and urinary glucose in t2dm-ild group were significantly higher than those in simple ILD group（P<0.05）;Pa O2 level was significantly lower than that in ILD group（P<0.05）;There was no significant difference between the groups in the determination of Pa CO2,prothrombin time,partial prothrombin time,D-dimer,leukocyte count,neutrophil count,lymphocyte count,platelet count,hemoglobin,albumin,procalcitonin,serum creatinine,uric acid,urinary protein and urinary ketone body（P>0.05）.5.Comparison of blood lipid indexesCompared with simple T2 DM group,the levels of triglyceride,total cholesterol and low-density lipoprotein in ILD-T2 DM group were significantly higher than those in simple T2 DM group（P<0.05）;At the same time,there was no significant difference in the levels of high-density lipoprotein,apolipoprotein A,apolipoprotein B,lipoprotein A and free fatty acid between ILD-T2 DM group and simple T2 DM group.Compared with simple ILD group,the levels of triglyceride and total cholesterol in ILD-T2 DM group were significantly higher than those in simple T2 DM group（P<0.05）;At the same time,there was no significant difference in the levels of low-density lipoprotein,high-density lipoprotein,apolipoprotein A,apolipoprotein B,lipoprotein A and free fatty acid between ILD-T2 DM group and simple T2 DM group.6.Comparison of pulmonary function indexes.In ILD-T2 DM group,the levels of FEV1 real/pre%,FVC real/pre%,KCO real/pre%,TLC real/pre%,DLCO real/pre% in ILD-T2 DM group were significantly lower than those in ILD group（p < 0.05）.There was no statistical significance between the two groups in FEV1/FVC%,FEV1/VC max%,PEF real/pre%.7.Regression analysis of multi-factor Logistics.The critical value of the duration of type 2 diabetes mellitus is 9.5 years,the AUC was 0.742（95% CI: 0.646 ～ 0.838）,the sensitivity was 67.3%,the specificity was 74.0%,p < 0.001;the Hb A1 c was 8.65%,the AUC was 0.778（95% ci: 0.690 ～0.867）,the sensitivity was 59.6%,the specificity was 86.0%,p < 0.001;The critical value of hs-CRP was 3.615 mg/l,the AUC was 0.714（95% ci: 0.615 ～ 0.814）,the sensitivity was 69.2%,the specificity was 68.0%,p < 0.001.Conclusions:1、Type 2 diabetes duration and Hb A1 c are closely related to the occurrence ofinterstitial lung disease associated with type 2 diabetes.2、Type 2 diabetes complicated with interstitial lung disease early pulmonaryfunction is ventilation dysfunction.3、Hyperlipidemia in type 2 diabetic patients may be an important risk factor forinterstitial lung disease.