ABSTRACT
Objective:To explore the correlation between lower gastrointestinal tract symptoms and diabetic retinopathy and lower extremity artery disease in patients with type 2 diabetic mellitus.Methods:The clinical data of 128 patients with type 2 diabetic mellitus from August 2016 to March 2018 in Central Hospital of Shengli OilField were retrospectively analyzed. The general clinical data and laboratory indexes were recorded. The score was evaluated by lower gastrointestinal symptoms rating scale (LGSRS). Patients with the LGSRS score ≥6 scores were as positive group, and those with LGSRS score<6 scores were as negative group. Fundus photography and ultrasonic scanning of lower extremity artery disease were performed for each patient. The correlation between LGSRS score and diabetic retinopathy, lower extremity artery disease was analyzed by Logistic regression.Results:Positive group had 66 cases, and negative group had 62 cases. The age, duration of diabetic, LGSRS score and incidence of diabetic retinopathy in positive group were significantly higher than those in negative group: (64.24 ± 10.43) years vs. (59.57 ± 12.50) years, (14.67 ± 1.28) years vs. (10.98 ± 1.25) years, (8.65 ± 2.38) scores vs. (2.77 ± 1.49) scores and 98.48% (65/66) vs. 69.35% (43/62), and there were statistical differences ( P<0.05 or<0.01). There were no statistical difference in gender, body mass index, glycated hemoglobin, fasting blood glucose, 2 h postprandial blood glucose, triglyceride, total cholesterol and incidence of diabetic retinopathy between 2 groups ( P>0.05). After adjusting for age, duration of diabetic, glycated hemoglobin, fasting blood glucose, triglyceride and total cholesterol, the LGSRS score showed positive correlation with diabetic lower extremity artery disease ( OR = 1.174, 95% CI 1.065 to 1.470, P = 0.001), but there was no correlation between LGSRS score and diabetic retinopathy ( P = 0.313). Conclusions:In patients with type 2 diabetes mellitus, lower gastrointestinal tract symptoms has positive correlation with diabetic lower extremity artery disease, and no correlation with diabetic retinopathy. It suggests that there may be a common pathological mechanism between lower gastrointestinal tract symptoms and diabetic lower extremity artery disease.
ABSTRACT
OBJECTIVE: To study the association between superior mesenteric artery hemodynamic indexes and scores of lower gastrointestinal symptoms rating scales(LGSRS) in patients with type 2 diabetic mellitus. METHODS: Totally 142 inpatients with type 2 diabetes with average age of 58.76±12.32 yrs were enrolled, who were treated from August 2016 to March 2018. The history, gender, age,course and BMI were recorded, and fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), 2-hour postprandial blood glucose(PBG), total cholesterol(TC), triglyceride(TG), urine ACR and LGSRS were determined. Ultrasonic scanning of mesenteric artery was performed for hemodynamic indexes, including artery inner diameter(ID), peak systolic velocity(PSV), end-diastolic velocity(EDV), and resistance index(RI)at starting part,first level branch, and second level branch from root of the superior mesenteric artery(SMA).Patients were divided into 2 groups according to their LGSRS, 74 patients with LGSRS≥6 were in positive group, and 68 patients with LGSRS0.05), but the age and DD were significantly higher in positive group than in control group(P0.05). 3. There were no significant difference between positive group and control group in ID at starting part and first level branch of SMA, while ID at second level branch was significantly increased in positive group compared with control group [(3.83±0.85)mm vs.(3.53±0.90)mm, P<0.05)].4. RI at first(0.816±0.059 vs 0.842±0.063,P<0.05) and second level branch(0.813±0.076 vs 0.845±0.073, P<0.05) and PSV at first level branch[(110.89±46.89)cm/s vs(95.72±36.59)cm/s,P<0.05] were significantly high in positive group; there were no difference in other hemodynamic indexes between the groups. 5.Adjusted by age,DD,glycemic and lipidemic profile,Logistic regression showed that ID at first(RR=2.092,95%CI 1.080-4.050,P=0.029) and second level branch(RR=0.491,95%CI 0.252-0.955,P=0.36) and EDV at second level branch(RR=0.897,95%CI 0.824-0.976,P=0.012) were independent factors influencing LGSRS(P<0.05). CONCLUSION: Ultrosonic hemodynamic abnormalities in the superior mesenteric artery might be important factor in development of lower gastrointestinal tract symptoms in patients with type 2 diabetes.