Subjects
Between 2019 and 2021, patients with T2DM were enrolled in our Inpatient Department of Endocrinology and Metabolism at the Third Affiliated Hospital of Nanchang University. The inclusion criteria for the subjects were:(1) Age, from 18–75 years; (2) T2DM was diagnosed using the 1999 World Health Organization (WHO) diagnostic criteria; (3) Patients volunteered to participate. Participants' exclusion criteria were (1) severe liver or kidney dysfunction; (2) acute DM complications; (3 ) bilateral lower extremity edema, severe cardiac dysfunction; (4) malignant tumor or pregnancy; (4) cannot cooperate with the examination. In the end, 322 T2DM patients were enrolled. The reference mean values of baPWV in the Central Asian population were used as cut-off values[8]. The enrolled cases were divided into two groups: Group 1 (༜the reference cutoff value, n = 160) and Group 2 (≥ the reference cutoff value, n = 162).
The Collection Of Data
We obtained basic clinical information from those subjects, such as their name, ages, duration of diabetes, past medical history, and personal history. Furthermore, general vital signs such as blood pressure, weight, and height were routinely measured in patients. The Body Mass Index (BMI) was calculated as weight (kg)/height(㎡).
Each subject had 3 ml of peripheral venous blood collected and anticoagulated with EDTA. All blood samples were obtained after 8h of fasting, then analyzed for Fasting Plasma Glucose (FPG), 2-hour Blood Glucose (2h-BG), glycosylated Hemoglobin (HbA1c), Fasting C-Peptide (FCP), Total Cholesterol (TC), Triglycerides (TG), High-Density Lipoprotein Cholesterol (HDL-C), Low-Density Lipoprotein Cholesterol (LDL-C), Serum creatinine (Scr), Serum Uric Acid (SUA), Blood Urea Nitrogen (BUN), among others.
Measurement Of Bapwv
Subjects rested in a quiet room for at least 15 minutes in a supine position without pillows before baPWV was measured by a professional using an automated atherosclerosis detector (BP-203RPCE, OMRON, Japan). The subject's hands were placed at the sides of the body, with both upper arms and ankles cuffed. An electrocardiogram sensor was placed in the precordial region, after which the device automatically recorded and analyzed the data. The mean value of baPWV measured on either side of each patient was used for analysis.
Examination And Diagnosis Of Microvascular Complications Of T2dm
We used the appropriate methods to diagnose DR, DN, and DPN.
According to the International Clinical Grading Criteria for DR, professionals classified patients' fundus photographic findings as mild, moderate, severe non-proliferate and proliferate[9].
Subject history, sensory testing (ankle reflex, temperature sensation, pinprick sensation, pressure sensation), and nerve conduction measurements with the electromyography/evoked potential detection system instrument(CADWELL LABORATORIES, INC), are all part of the DPN examination. Finally, subjects were diagnosed for the presence of DPN based on diagnosis and classification of diabetes mellitus[10].
The urinary microprotein and creatinine levels in subjects’ fasting morning urine were determined using dry chemistry, then the urine microprotein to creatinine ratio was calculated. These biochemical indicators are used to identify and classify DN[10]. Moreover, other causes of chronic kidney disease were excluded.
Statistical analysis
Subjects were divided into two groups based on their baPWV (One group was above the reference cutoff value and the other was below it). Continuous variables have a normal or nearly normal distribution, which is expressed as mean ± standard deviation. For continuous variables, the difference between the two groups was tested using unpaired Student’s test, while X²test was used for categorical variables. Additionally, participants were divided into two groups each time based on the presence of DR, DN or DPN. The two groups were compared by unpaired Student’s test, while one-way ANOVA was used for multiple group measurement data. After entering statistically significant variables data from the t-test into multivariate linear regression analysis, independent risk factors were screened. The Statistical Package for the Social Sciences version 25 (SPSS 25.0) was used for all statistical analyses at p < 0.05 or p < 0.01.