2457-PUB: Microcirculatory Alterations Are Associated with Increased Risk of Total Death in Patients with Type 2 Diabetes

Abstract

Rationale and Objective: It has been well known that patients with diabetes had shorter life expectancy, compared to patients without diabetes. Although several studies have been reported the significance of microciculatory dysfunction particularly in the early phase of critical illness, it has been not reported the association between microcirculatory dysfunction and long-term prognosis. Therefore, we evaluated the relationship between microcirculatory dysfunction and the risk of total death in patients with type 2 diabetes. Methods: A total of 1017 patients with diabetes (657 men and 360 women), who were admitted to the department of internal medicine from September 2015 to December 2017, were included in this study. We measured perfusion index (PI), which could reflect microcirculation, using a pulse oximeter (Masimo Radical 7; Masimo Corp., Irvine, CA, U.S.) on the day of admission. Cox proportional hazards models was used in multivariate analysis. Results: The median duration of follow-up was 670.0 days and a total of 117 patients died during follow-up duration. The average age, HbA1c and PI value was 71.0 ± 11.6 years, 7.7 ± 1.9% and 3.2 ± 2.4%. PI value was negatively correlated with age (β = -0.18, P < 0.0001), pulse rate (β = -0.06, P = 0.04) and serum creatinine (β = -0.16, P < 0.0001). PI value was positively correlated with body mass index (β = 0.11, P = 0.0007) and hemoglobin level (β = 0.19, P < 0.0001). Adjusted Cox regression analyses demonstrated that PI value was associated with an increased hazard of total death; hazard ratios were 1.11 (95% confidence interval, 1.01 - 1.23). Conclusion: The present study indicates the importance of microciculatory dysfunction and monitoring as a potential independent prognostic factor of mortality in patients with type 2 diabetes. Disclosure H. Okada: None. Y. Okada: None. M. Fukui: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Johnson & Johnson, Kyowa Hakko Kirin Co., Ltd., Merck & Co., Inc., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; AstraZeneca, Eli Lilly and Company, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Merck & Co., Inc., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited.