Evaluation of left ventricular systolic function in type 2 diabetes mellitus patients with and without peripheral vascular disease

BACKGROUND Peripheral vascular disease(PVD)is a common complication of type 2 diabetes mellitus(T2DM).Patients with T2DM have twice the risk of PVD as nondiabetic patients.AIM To evaluate left ventricular(LV)systolic function by layer-specific global longitudinal strain(GLS)and peak strain dispersion(PSD)in T2DM patients with and without PVD.METHODS Sixty-five T2DM patients without PVD,57 T2DM patients with PVD and 63 normal controls were enrolled in the study.Layer-specific GLS[GLS of the epimyocardium(GLSepi),GLS of the middle myocardium(GLSmid)and GLS of the endocardium(GLSendo)]and PSD were calculated.Receiver operating characteristic(ROC)analysis was performed to calculate the sensitivity and specificity of LV systolic dysfunction in T2DM patients with PVD.We calculated Pearson’s correlation coefficients between biochemical data,echocardiographic characteristics,and layer-specific GLS and PSD.RESULTS There were significant differences in GLSepi,GLSmid and GLSendo between normal controls,T2DM patients without PVD and T2DM patients with PVD(P<0.001).Trend tests revealed a ranking of normal controls>T2DM patients without PVD>T2DM patients with PVD in the absolute value of GLS(P<0.001).PSD differed significantly between the three groups,and the trend ranking was as follows:normal controls<T2DM patients without PVD<T2DM patients with PVD(P<0.001).ROC analysis revealed that the combination of layer-specific GLS and PSD had high diagnostic efficiency for detecting LV systolic dysfunction in T2DM patients with PVD.Lowdensity lipoprotein cholesterol was positively correlated with GLSepi,GLSmid and PSD(P<0.05),while LV ejection fraction was negatively correlated with GLSepi,GLSmid and GLSendo in T2DM patients with PVD(P<0.01).CONCLUSION PVD may aggravate the deterioration of LV systolic dysfunction in T2DM patients.Layer-specific GLS and PSD can be used to detect LV systolic dysfunction accurately and conveniently in T2DM patients with or without PVD.

Obesity, Diabetes Mellitus and Vascular Disease: A Complex Relationship with Prostate Cancer

Background: Obesity, type II Diabetes mellitus (DMII) and vascular damage could be implicated in prostate cancer (PCa) nevertheless no clear results has been reached. The aim of the research was to investigate the association of these alterations with PCa at initial diagnosis, without the influence of hormone therapy or chemotherapy. Methods: Retrospective analysis of 400 patients undergoing prostate biopsy at our institution between 2005 and 2012 was conducted. We examined associations of obesity, DMII and vascular damage in 200 patients with PCa diagnosis versus 200 age-matched controls. Men with history of hormone therapy or chemotherapy, prostate or bladder surgery were excluded. Results: Obesity was significantly associated (OR 2.10, p < 0.05) with aggressive PCa (Gleason Score 8 - 10). DMII was significantly associated to aggressive PCa but only in obese cases (OR 4.25). Carotid vascular disease (CVD) and coronary artery disease (CAD) were significantly linked to PCa in all cases versus controls (OR 1.88, p < 0.05). Conclusions: In our study, obesity, particularly in combination with DMII, was significantly associated with aggressive PCa. Moreover, a significant relation was found between vascular disease and PCa hormone-naive at initial diagnosis. The metabolic derangements associated to obesity and DMII may increase oxidative stress and cause a permanent pro-inflammatory state that predisposes to vascular disease and PCa.

Understanding the multifaceted etiopathogenesis of foot complications in individuals with diabetes

Diabetes mellitus,a chronic disease of metabolism,is characterized by a disordered production or cellular utilization of insulin.Diabetic foot disease,which comprises the spectrum of infection,ulceration,and gangrene,is one of the most severe complications of diabetes and is the most common cause of hospitalization in diabetic patients.The aim of this study is to provide an evidence-based overview of diabetic foot complications.Due to neuropathy,diabetic foot infections can occur in the form of ulcers and minor skin lesions.In patients with diabetic foot ulcers,ischemia and infection are the main causes of non-healing ulcers and amputations.Hyperglycemia compromises the immune system of individuals with diabetes,leading to persistent inflammation and delayed wound healing.In addition,the treatment of diabetic foot infections is challenging due to difficulty in accurate identification of pathogenic microorganisms and the widespread issue of antimicrobial resistance.As a further complicating factor,the warning signs and symptoms of diabetic foot problems can easily be overlooked.Issues associated with diabetic foot complications include peripheral arterial disease and osteomyelitis;accordingly,the risk of these complications in people with diabetes should be assessed annually.Although antimicrobial agents represent the mainstay of treatment for diabetic foot infections,if peripheral arterial disease is present,revascularization should be considered to prevent limb amputation.A multidisciplinary approach to the prevention,diagnosis,and treatment of diabetic patients,including those with foot ulcers,is of the utmost importance to reduce the cost of treatment and avoid major adverse consequences such as amputation.

Relationship of visual impairment and peripheral artery disease with the occurrence of diabetic foot ulcers in Dr. Moewardi Hospital

Objective: One of the diabetes mellitus (DM) complications is foot ulcers. Foot ulcers are influenced by many factors. DM puts patients at risk of injury because of visual impairment. Hyperglycemia can damage blood vessels, which results in peripheral artery disease (PAD). The purpose of this study was to find the relationship of visual impairment and PAD with diabetic foot ulcers. Methods: This research used observational analytic study with case–control methods. It used purposive sampling in 34 DM patients with foot ulcers and 34 DM patients without foot ulcers. The research instruments were an interview guide to assess visual impairment, physical examination to assess PAD, and documentation study, which was used to know the incidence of diabetic ulcers. Results: The results showed that the respondents who experienced ulcers with visual impairment were 44.1% and the respondents who had foot ulcers with PAD were 73.5%. The results of statistical tests showed that there was no relationship between visual impairment and the incidence of ulcers (P = 0.166). The respondents with PAD will have a chance to suffer from foot ulcers 5.808 times higher than those who do not have PAD. Conclusions: There is no relationship between visual impairment and the incidence of diabetic foot ulcers in Dr. Moewardi Hospital, but there is relationship between PAD and the incidence of diabetic foot ulcers in Dr. Moewardi Hospital. Suggestions of this study are to do foot screening and educate about the importance of foot care to prevent the occurrence of diabetic ulcers.

Current Status of Traditional Chinese and Western Medicine Treatment of Diabetic Peripheral Vascular Disease

Diabetic peripheral vascular disease(PVD)is one of the common chronic complications of diabetes.The main clinical manifestations of PVD are numbness and coldness of the limbs,resting pain,intermittent claudication,and other symptoms.The combined treatment involving Chinese and Western medicine for PVD has various clinical methods and definite curative effects.It is worthy of in-depth clinical research and application.

mTOR: Driving apoptosis and autophagy for neurocardiac complications of diabetes mellitus

The World Health Organization estimates that diabetes mellitus(DM) will become the seventh leading cause of death during the next two decades. DM affects approximately 350 million individuals worldwide and additional millions that remain undiagnosed are estimated to suffer from the complications of DM. Although the complications of DM can be seen throughout the body, the nervous, cardiac, and vascular systems can be significantly affected and lead to disorders that include cognitive loss, stroke, atherosclerosis, cardiac failure, and endothelial stem cell impairment. At the cellular level, oxidativestress is a significant determinant of cell fate during DM and leads to endoplasmic reticulum stress, mitochondrial dysfunction, apoptosis, and autophagy. Multiple strategies are being developed to combat the complications of DM, but it is the mechanistic target of rapamycin(mTOR) that is gaining interest in drug development circles especially for protective therapies that involve cytokines and growth factors such as erythropoietin. The pathways of mTOR linked to mTOR complex 1, mTOR complex 2, AMP activated protein kinase, and the hamartin(tuberous sclerosis 1)/tuberin(tuberous sclerosis 2) complex can ultimately influence neuronal, cardiac, and vascular cell survival during oxidant stress in DM through a fine interplay between apoptosis and autophagy. Further understanding of these mTOR regulated pathways should foster novel strategies for the complications of DM that impact millions of individuals with death and disability.

PREVALENCE AND RISK FACTORS OF PERIPHERAL ARTERIAL DISEASE IN DIABETIC PATIENTS OVER 50 YEARS OLD IN CHINA

Objective To investigate the prevalence of peripheral arterial disease (PAD) in China type 2 diabetic patients and to demonstrate the relationships between putative risk factors and PAD. Methods In total 1 397 type 2 diabetic patients aged 50 years and older were enrolled and determined ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) in 15 Class III Grade A hospitals in 7 major cities of China. Results Mean patient age was 63.7±8.2 years and mean duration of diabetes mellitus was 9.39±7.4 years. Two hundreds and seventy-two (19.47%) patients were diagnosed as PAD by ABI <0.9, 122 (18.37%) in male and 150 (20.46%) in female. PAD patients had a significantly longer duration of diabetes mellitus, higher hemoglobin Alc, and a significantly lower mean body mass index than non-PAD ones. Aging, smoking, and systolic blood pressure were found to be positively related with the prevalence of PAD. In terms of lipid profiles, no variable was found to relate with PAD. Notably, baPWV showed as the same significant guiding index for PAD, almost matched with ABI. Conclusions PAD is a common complication in China type 2 diabetic patients. Therefore, PAD screening and treatment should be emphasized for diabetic patients with high risk factors.

Cognitive disorder and dementia in type 2 diabetes mellitus

Insulin,a key pleiotropic hormone,regulates metabolism through several signaling pathways in target tissues including skeletal muscle,liver,and brain.In the brain,insulin modulates learning and memory,and impaired insulin signaling is associated with metabolic dysregulation and neurodegenerative diseases.At the receptor level,in aging and Alzheimer’s disease(AD)models,the amount of insulin receptors and their functions are decreased.Clinical and animal model studies suggest that memory improvements are due to changes in insulin levels.Furthermore,diabetes mellitus(DM)and insulin resistance are associated with age-related cognitive decline,increased levels ofβ-amyloid peptide,phosphorylation of tau protein;oxidative stress,pro-inflammatory cytokine production and dyslipidemia. Recent evidence shows that deleting brain insulin receptors leads to mildobesity and insulin resistance without influencing brain size and apoptosis development.Conversely, deleting insulin-like growth factor 1 receptor (IGF-1R) affects brain size anddevelopment, and contributes to behavior changes. Insulin is synthesized locally in the brain andis released from the neurons. Here, we reviewed proposed pathophysiological hypotheses toexplain increased risk of dementia in the presence of DM. Regardless of the exact sequence ofevents leading to neurodegeneration, there is strong evidence that mitochondrial dysfunctionplays a key role in AD and DM. A triple transgenic mouse model of AD showed mitochondrialdysfunction, oxidative stress, and loss of synaptic integrity. These alterations are comparable tothose induced in wild-type mice treated with sucrose, which is consistent with the proposal thatmitochondrial alterations are associated with DM and contribute to AD development. Alterationsin insulin/IGF-1 signaling in DM could lead to mitochondrial dysfunction and low antioxidantcapacity of the cell. Thus, insulin/IGF-1 signaling is important for increased neural processing andsystemic metabolism, and could be a specific target for therapeutic strategies to decreasealterations associated with age-related cognitive decline.

Pathogenesis of diabetic cerebral vascular disease complication

Diabetes mellitus is one of the most potent independent risk factors for the development of diabetic cerebral vascular disease(CVD). Many evidences suggested that hyperglycemia caused excess free fatty acids, the loss of endothelium-derived nitric oxide, insulin resistance, the prothrombotic state, endothelial dysfunction, the abnormal release of endothelial vasoactivators,vascular smooth muscle dysfunction, oxidative stress, and the downregulation of mi Rs participated in vessel generation and recovery as well as the balance of endotheliocytes. In turn, these abnormalities, mainly via phosphatidylinositol 3 kinase, mitogen-activated protein kinase, polyol, hexosamine, protein kinase C activation, and increased generation of advanced glycosylation end products pathway, play an important role in inducing diabetic CVD complication. A deeper comprehension of pathogenesis producing diabetic CVD could offer base for developing new therapeutic ways preventing diabetic CVD complications, therefore, in the paper we mainly reviewed present information about the possible pathogenesis of diabetic CVD complication.

IMPAIRED ANGIOGENESIS FOLLOWING HIND-LIMB ISCHEMIA IN DIABETES MELLITUS MICE

Objective To investigate vascular endothelial growth factor(VEGF) and its signaling pathway spontaneous response in type 2 diabetes mellitus(T2DM) mice to surgery-induced hind-limb ischemia.Methods Sixty mice were randomly divided into two groups,one was fed with normal chow as control,and another was fed with high fat diet to induce T2DM.Fourteen weeks later,mice were surgically induced to hind-limb ischemia.Blood flow restoration was monitored with laser Doppler perfusion imaging.Tibialis anterior muscle was collected after 3 days of hind-limb ischemia.VEGF mRNA and protein expressions were analyzed using real-time PCR and ELISA;expressions of VEGF downstream signal molecules and receptors were analyzed using Western blotting and RT-PCR,respectively.Results Perfusion recovery 10,20,30 days after ischemia was significantly attenuated in T2DM compared with control group(P<0.05).T2DM impaired VEGF signaling pathway although VEGF levels increased in T2DM group.After ischemia,T2DM group had a comparable increase in VEGF expression compared with control group,but still had an impaired VEGF signaling pathway.Conclusion VEGF signaling pathway is abnormal in T2DM mice,although VEGF had a response to the ischemic stimulation.

Accuracy of Doppler Ultrasonography in Assessment of Lower Extremity Peripheral Arterial Diseases

Doppler ultrasound scan is a non-invasive, cheap and convenient tool and it complements angiography, Computed tomography angiography (CTA), magnetic resonance angiography (MRA) and catheter digital subtraction angiography (DSA) in screening, diagnosis, treatment and follow-up of peripheral vascular diseases. Symptoms of peripheral vascular diseases are becoming more common due to rise in incidence of diseases and risk factors (diabetes mellitus, dyslipidemias, smoking, sedentary lifestyle). Due to limited availability of highly specific tools such as CT angiography, magnetic resonance angiography (MRA) and DSA (digital subtraction angiography) in many developing countries, doppler ultrasound is gaining more importance. Early determination of peripheral arterial diseases is beneficial in prevention of complications as severity increases may cause intermittent claudication, pain, tissue loss, including ulceration and gangrene (as the diseases progresses) and early management of arteriosclerosis will be beneficial to prevent these complications.

Clinical Parameters of Metabolic Control (HbA_(1c)) and Deterioration of Peripheral Arterial Perfusion in Type 2 Diabetes

Objective: To determine the relationship between clinical parameters (HbA1c) whit metabolic control and deterioration of peripheral arterial perfusion in diabetic patients. Methodology: 108 medical records of patients with type 2 diabetes mellitus were evaluated. We obtained averages of: blood glucose (162.3 ± 73.10 mg/dl), glycated hemoglobin (HbA1c = 7.64% ± 1.77%), cholesterol (189.28 ± 35.25 mg/dl), triglycerides (189.11 ± 87.76 mg/dl), Systolic Blood Pressure (SBP = 119.69 ± 14.95 mmHg), Diastolic Blood Pressure (DBP = 77.15 ± 9.55 mmHg) and Media Blood Pressure (MBP = 91.36 ± 9.89 mmHg). We correlated variable HbA1c with vascular injury symptomatology. Results: Correlation was found between sensitivity dysfunction and HbA1c with a statistical significance of p = 0.01, and a correlation Kendal coefficient w = 0.01, any other parameter of metabolic control was not correlated with symptoms of vascular injury. Conclusion: It is remarkable that the sensitivity dysfunction is a symptom of poorly vascularized lower extremities caused for both functional impairment and structural changes in diabetic patients’ peripheral nerves, even in the preclinical stage of vascular disease. The HbA1c could also be investigated as a likely sensitivity dysfunction biomarker in DM due to the correlation presented in this study but more studies must be realized.

Clinical analysis of 35 cases of peripheral arterial disease

Objective To analyse the current condition in diagnosis and treatment of peripheral arterial disease (PAD). Methods:35 cases of PAD hospitalized between July 2007 and May 2008 were collected and studied.Results:14 of them had the concomitant type 2,diabetes mellitus (shortly as DM) and 18 cases with ulcers or gangrene in the lower limb,up to 14 were found with DM.5 died of pulmonary infection and 1 died of multiple system organ failure (MSOF).Conclu- sion:DM was an important risk factor of PAD.PAD tended to start in younger age in those with DM and its local lesion was frequently more severe and often less effective in revasculation treatment.Death during hospitalization was mainly due to related complications from cerebral vascular problems but not DM.

气阴两虚夹瘀型2型糖尿病患者外周血LncRNA TUG 1与血管病变标志因子的相关性

目的分析气阴两虚夹瘀型2型糖尿病患者外周血长链非编码RNA牛磺酸调节基因1(long non-coding RNA taurine regulatory gene 1,LncRNA TUG1)与血管病变因子的相关性。方法随机选取该院内分泌科住院的气阴两虚夹瘀型2型糖尿病患者50例作为观察组,另选取46例健康体检者作为健康对照组。检测餐后2 h血糖(2-hour postprandial blood glucose,2 h PG)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、内皮素(endothelin,ET)、一氧化氮(nitric oxide,NO)水平及LncRNA TUG1表达;经Pearson线性相关分析,血清LncRNA TUG1与ET、NO、HbA1c、血糖指标的相关性。结果与健康对照组比较,气阴两虚夹瘀型2型糖尿病患者LncRNA TUG1、HbA1c、FPG、2 h PG、ET水平明显升高(P<0.01),NO水平明显降低(P<0.01),差异具有统计学意义。Pearson相关性分析显示,LncRNA TUG1与NO水平呈显著负相关(P<0.01);与ET、HbA1c、FPG、2 h PG水平呈显著正相关(P<0.01)。结论气阴两虚夹瘀型2型糖尿病患者外周血LncRNA TUG1高表达,与HbA1c、ET、血糖呈正相关,与NO水平呈负相关,与血管病变标志因子关系密切,存在一定的相关性,可作为潜在预测指标。

早期量化功能锻炼联合中医三联干预措施对糖尿病周围血管病变患者的影响

目的:观察早期量化功能锻炼联合中医三联干预措施对糖尿病周围血管病变患者的影响。方法:将68例糖尿病周围血管病变患者按照随机数字表法分为对照组和研究组各34例,对照组采用常规护理措施,研究组采用早期量化功能锻炼联合中医三联干预措施,比较两组患者干预前后下肢动脉血流量、负性情绪评分及干预后糖尿病生活质量特异性量表(diabetes specific quality of lifescale,DSQL)总评分与护理效果。结果:干预1个月后,两组患者下肢动脉血流量高于干预前,研究组高于对照组(P<0.05);两组患者焦虑自评量表、抑郁自评量表评分低于干预前,研究组低于对照组(P<0.05);研究组DSQL总评分低于对照组(P<0.05),研究组总有效率为97.06%(33/34),高于对照组的79.41%(27/34)(P<0.05)。结论:早期量化功能锻炼联合中医三联干预措施能增加糖尿病周围血管病变患者下肢动脉血流量,提高患者生活质量和护理效果,改善患者不良情绪。

Effect of Shengmai Injection (生脉注射液) on Vascular Endothelial and Heart Functions in Patients with Coronary Heart Disease Complicated with Diabetes Mellitus

Objective： To study the effect of Shengmai injection （生脉注射液, SMI） on vascular endothelial and heart functions in coronary heart disease patients complicated with diabetes mellitus （CHD-DM）. Methods： One hundred and twenty patients with CHD-DM, their diagnosis confirmed by coronary arteriography, were equally randomized into a control group treated with conventional treatment and a treated group treated with conventional treatment plus SMI. The changes in blood levels of nitric oxide （NO）, endothelin-1 （ET-1） and angiotensin Ⅱ （Ang Ⅱ）, as well as endothelium-dependent vascular dilating function and heart function in the patients were observed before treatment and after the 3-week treatment. Results： After being treated with SMI for 3 weeks, in the treated group, blood level of NO was raised significantly from 69.8±33.1 μmol/L to 120.1±50.8μmol/L, and ET-1 was lowered from 70.1±32.1 ng/L to 46.2±21.3 ng/L, respectively （P〈0.01）; that of Ang Ⅱ was lowered from 81.3±24.3 ng/L to 50.2±27.3 ng/L （P〈0.01）; brachial arterial post-congestion blood flow increasing rate was raised from 389.4±26.3% to 459.3±27.8% （P〈0.01）; and the improvement in heart function as seen through the ejection fraction （EF） was increased from 44±5% to 68±6% （P〈0.01）, all the changes being more significant than those in the control group （all P〈0.01）. Conclusion： SMI can improve not only the endothelial function in CHD-DM patients, but also heart contraction significantly.

活血防塞汤改善气虚痰瘀型老年2型糖尿病下肢血管腔内治疗术后症状的临床观察

目的探讨活血防塞汤对气虚痰瘀型老年糖尿病下肢血管腔内治疗术后临床症状的影响。方法选取2019年9月-2020年9月于天津中医药大学第二附属医院行下肢血管腔内治疗的老年2型糖尿病足患者88例,以数字表随机法分为对照组和观察组,每组44例。对照组行术后常规治疗,观察组在对照组基础上加用活血防塞汤治疗,2组均治疗2周。比较2组治疗后的临床疗效、经皮氧分压、肢体水肿以及症状评分。比较2组治疗前及治疗2周后患者血清白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平。结果治疗2周后,观察组有效率显著高于对照组(P<0.05),经皮氧分压水平显著高于对照组(P<0.05),肢体水肿评分显著低于对照组(P<0.05),足部单项症状(疼痛、冷感)评分低于对照组(P<0.05),CRP、IL-6、TNF-α表达水平低于对照组(P<0.05或P<0.01)。结论活血防塞汤能够显著改善老年糖尿病下肢血管腔内治疗术后的临床症状,其机制可能与抑制炎症因子IL-6、TNF-α、CRP表达有关。

2型糖尿病患者下肢血管病变的影响因素分析

目的:探讨2型糖尿病患者下肢血管病变的影响因素。方法:选取2019年8月—2023年3月安徽医科大学第一附属医院收治的2型糖尿病患者91例作为研究对象,根据下肢血管超声检查结果分为下肢血管病变组(n=56)和下肢血管未病变组(n=35)。比较两组临床资料,分析2型糖尿病患者下肢血管病变的影响因素。结果:下肢血管病变组年龄大于下肢血管未病变组,病程长于下肢血管未病变组,同型半胱氨酸水平高于下肢血管未病变组,差异有统计学意义(P<0.05)。年龄为2型糖尿病患者下肢血管病变的独立危险因素(P<0.05)。结论:年龄是2型糖尿病患者发生下肢血管病变的独立危险因素,且下肢血管病变患者糖尿病病程较长,同型半胱氨酸水平较高,临床应予以重视,控制和改善糖尿病患者下肢血管病变的发生、发展。

基于中医传承辅助系统分析中医药治疗糖尿病下肢血管病变的组方规律

目的挖掘国内关于中医药治疗糖尿病下肢血管病变的文献,探索糖尿病下肢血管病变的中药组方用药规律及特点。方法通过检索维普、万方和CNKI等数据库,筛选纳入中医药治疗糖尿病下肢血管病变的文献,运用中医传承辅助系统(Traditional Chinese Medicine Inheritance Support System,TCMISS)2.5软件建立数据库并进行数据分析。结果共筛选出54个中药复方用于治疗糖尿病下肢血管病变,其中出现频次超过20次的药物分别为黄芪、川芎、当归、丹参、桂枝、水蛭、牛膝和地龙,进一步挖掘出44个高频药对,提炼核心组合12个,形成新处方5个。结论借助TCMISS软件定量分析药物之间的关联性,分析各医家治疗糖尿病下肢血管病变的用药经验和方药规律,凝练出糖尿病下肢血管病变的治疗新处方。

2型糖尿病患者血清miR-103a和miR-497水平表达与微血管病变发生的相关性研究

目的探究2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清微小RNA-103a(miR-103a),微小RNA-497(miR-497)水平表达与微血管病变(micro vascular disease,MVD)发生的相关性。方法选取2022年5月~2023年4月在唐山市协和医院确诊的T2DM患者作为研究组(n=113),根据是否并发MVD分为2型糖尿病微血管病变(type2 diabetes microangiopathy,DMAP)组(n=51)和T2DM(n=62)组,选取同期体检健康人员作为对照组(n=105)。收集患者临床资料,实时荧光聚合酶链反应(real-time fluorescence polymerase chain reaction,qRT-PCR)检测血清miR-103a和miR-497水平,采用Logistic回归分析T2DM并发MVD的影响因素,绘制受试者工作特征(receiver operatingcharacteristic,ROC)曲线分析血清miR-103a和miR-497水平对T2DM并发MVD的诊断价值。结果研究组血清miR-103a(0.62±0.13)和miR-497(0.79±0.14)水平显著低于对照组(0.96±0.16,1.03±0.18),差异具有统计学意义(t=17.273,11.031,均P<0.05)。DMAP组血清miR-103a(0.53±0.08)和miR-497(0.69±0.10)水平显著低于T2DM组(0.69±0.10,0.87±0.13),差异具有统计学意义(t=9.247,8.108,均P<0.05)。DMAP组病程≥8年、并发高血脂患者比例、空腹血糖(FBG)、总胆固醇(TC)、血肌酐(Scr)和尿素氮(BUN)水平显著高于T2DM组,差异具有统计学意义(t/χ2=8.294,15.342,-2.855,-5.659,-8.951,-3.880,均P<0.05)。血清miR-103a,miR-497及二者联合诊断T2DM并发MVD的曲线下面积(area under curve,AUC)分别为0.899,0.897和0.970,二者联合诊断效果优于各自单独诊断(Z=2.268,2.267,均P<0.05)。Logistic多因素回归分析结果显示FBG(OR=1.879,95%CI:1.262~2.797),TC(OR=2.141,95%CI:1.348~3.400)和Scr(OR=3.417,95%CI:1.569~7.440)是T2DM并发MVD的独立风险因素(均P<0.05),miR-103a(OR=0.784,95%CI:0.648~0.948)和miR-497(OR=0.839,95%CI:0.750~0.938)是T2DM并发MVD的保护因素(均P<0.05)。结论T2DM并发MVD患者血清miR-103a和miR-497低表达,其可能成为诊断T2DM并发MVD的潜在标志物。