Abstract:Objective: To investigate the correlation between plasma endothelin-1 (ET-1) level and the degree of lower extremity vascular disease in elderly patients with type 2 diabetes. Methods: A total of 136 elderly patients with diabetes mellitus and lower extremity vascular disease treated in our hospital from January 2015 to January 2019 were randomly selected. Based on the results of ankle brachial index (ABI) measurement in elderly patients, they were divided into a 84 patients mild lower extremity arteriosclerosis group (0.7≤ABI <0.9), a 36 patients moderate lower extremity arteriosclerosis group (0.5≤ABI <0.7), and a 16 patients severe lower extremity arteriosclerosis group (ABI <0.5),Glucose oxidase method was used to measure fasting blood glucose (FBG), chromatographic method was used to measure glycated hemoglobin (HbA1c), and automatic biochemical analyzer was used to measure the cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), and triacylglycerol (TG), etc. The enzyme-linked adsorption method was used to measure the plasma ET-1 levels in patients among different lower extremity arteriosclerosis groups, and we analyzed the correlation between the degree of aortic lesions in different limbs and the level of plasma ET-1 . Results: There were significant differences in age, BMI, TC, TG, LDL, HDL, course of disease, blood glucose under fasting, and ET-1 level between groups with different degrees of pathological changes of lower extremity arteries in type 2 diabetes (P <0.05). Logistic regression analysis showed that, fasting blood glucose, duration of diabetes, and ET-1 are independent risk factors that affect the degree of arterial disease in the lower limbs. Spearman rank correlation analysis showed that the degree of diabetic lower extremity vascular lesions was positively correlated with ET-1 (r = 0.336, P = 0.000). Conclusion: The independent risk factors for the degree of lower extremity vascular disease in type 2 diabetes are fasting blood glucose, duration of diabetes, which are positively correlated with ET-1 level.
[1] Bentata Y, Chemlal A, Karimi I, et al. Diabetic kidney disease and vascular comorbidities in patients with type 2 diabetes mellitus in a developing country[J]. Saudi Journal of Kidney Diseases & Transplantation An Official Publication of the Saudi Center for Organ Transplantation Saudi Arabia, 2015, 26(5):1035. [2] Mayyas F, Aljarrah M, Ibrahim K, et al. The significance of circulating endothelin-1 as a predictor of coronary artery disease status and clinical outcomes following coronary artery catheterization[J]. 2015, 24(1):19~25. [3] 李喜梅,王瑜,叶燕珍.不同程度下肢动脉硬化的2型糖尿病患者血压、血脂及内皮素水平比较[J].医学综述,2016,22(08):1649~1652. [4] 中华医学会糖尿病学分会,国家基层糖尿病防治管理办公室.国家基层糖尿病防治管理指南(2018)[J].中华内科杂志,2018,57(12):885~893. [5] 张磊,包明晶,吴冀川,等.2型糖尿病患者冠脉病变与下肢动脉和颈动脉病变的关系[J].四川医学,2016,37(10):1106~1109. [6] 徐浩,章鸯,唐彪,等.2型糖尿病患者发生颈动脉粥样硬化的危险因素分析[J].中国卫生检验杂志,2019,29(04):494~496. [7] 葛果,陈伟菊,许万萍,等.2型糖尿病患者周围血管病变的踝肱指数检测与相关因素分析[J].护士进修杂志,2016,31(04):291~293. [8] Sugiyama S, Jinnouchi H, Hieshima K, et al. A pilot study of ezetimibe vs. atorvastatin for improving peripheral microvascular endothelial function in stable patients with type 2diabetes mellitus[J]. Lipids Health Dis, 2015, 14( 1) : 37~41.