| ObjectiveTo explore the correlation between subclinical inflammatory index hypersensitive Creactive protein(hs-CRP)and type 2 diabetic cardiovascular autonomic neuropathy(DCAN),and evaluate the predictive value of related risk factors for cardiovascular autonomic neuropathy(CAN).Subjects and MethodsA total of 167 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology of Shaoxing People’s Hospital from 2021 to 2023 were randomly selected as research objects.All patients underwent cardiovascular standard reflex tests,and recorded clinical data and hs-CRP,etc.Biochemical Indicators.According to the Ewing test score,the patients were divided into DCAN group(≥2 points)and Non DCAN group(<2 points).The severity of CAN was further divided into normal group(0-0.5 points),early lesion group(1-1.5points),and confirmed group(≥2 points).Statistical analysis was performed using the statistical software SPSS Statistics 26.0.Results1.A total of 167 patients with type 2 diabetes were included in this study,34 cases were diagnosed as DCAN,and the prevalence rate of DCAN was 20.30%.2.Comparing the DCAN group and the Non DCAN group,it was found that there were statistical differences between the two groups in age,disease duration,diabetic complications,Hb A1 c,u ACR,hs-CRP,ALT,TG,and eGFR(P<0.05).3.Comparing the normal group,the early lesion group and the confirmed group,it was found that the hs-CRP levels of the three groups were significantly different(P<0.05),and the hs-CRP level of the confirmed group was higher than that of the early lesion group and the normal group(P<0.05),the early lesion group was higher than the normal group(P<0.05).4.Comparing the three groups of different hs-CRP levels,it was found that there were statistical differences among the course of disease,BMI,waist circumference,prevalence of diabetic retinopathy,ALT,TG,eGFR,PBG,Ewing score,and prevalence of DCAN(P<0.05).5.Age,course of disease,diabetic complications,eGFR,uACR,hs-CRP,ALT,TG,and four cardiovascular standard tests were risk factors for CAN in patients with type 2 diabetes(P<0.05).hs-CRP(OR 1.993 95% CI: 1.344,2.778 P<0.001)and TG(OR 4.479 95% CI: 1.821,11.014 P<0.05)levels increased,eGFR(OR 0.926 95% CI: 0.877,0.977 P <0.05)and the30/15 RR interval ratio(OR 0.001 95% CI: 0.001,0.065 P<0.05)were independent risk factors for CAN in patients with type 2 diabetes.6.The analysis of the survival curve showed that the area under the curve of the hs-CRP model was the largest,and the difference with the model of TG,eGFR,and 30/15 RR interval ratio in supine-standing position was statistically significant.The AUC of the hs-CRP model was 0.910(95% CI 0.856,0.965),the best cut-off value(Cut-off value)was 6.035,the specificity was 87.5%,and the sensitivity was 83.9%.Conclusions1.DCAN has a high prevalence rate in patients with type 2 diabetes.2.There is a significant correlation between the hs-CRP level and the risk of DCAN in patients with type 2 diabetes mellitus,and it gets worse with the severity of DCAN.3.The increase of hs-CRP and TG levels,the decrease of eGFR and the ratio of 30/15 RR interval in supine-stand position are independent risk factors for CAN in patients with type 2diabetes.4.Survival curve analysis shows that when the hs-CRP of patients with type 2 diabetes is greater than 6.035,although the upper limit of hs-CRP for cardiovascular risk has not been reached,timely intervention is still needed at this time,and CAN screening for patients with type 2 diabetes is strengthened. |
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