Metabolic Syndrome in Type 2 Diabetes Mellitus Patients: Prevalence, Risk Factors, and Associated Microvascular Complications

Diabetes mellitus (DM) long-term macrovascular and microvascular complications pose significant health risks and increase mortality. In DM patients, metabolic syndrome (MetSy) either precedes or coexists with the condition. Central obesity, poor glycemic control, hypertension, elevated triglycerides (TG), and low high-density lipoproteins (HDL-C) are the components of MetSy. The purpose of this study is to investigate related diabetic microvascular complications in type 1 DM (T1DM) by comparing them with type 2 DM (T2DM), determine potential risk factors, and estimate prevalence based on the diagnosis of MetSy. This study included 160 T1DM and 160 T2DM patients, totaling 320 DM patients. It was carried out from April 20, 2022, to September 31, 2023, at the Sheikh Zayed Hospital, Rahim Yar Khan, in the Outdoor Diabetic Clinic and Medicine Department. A unique questionnaire was utilized to gather socio-demographic, general, clinical, and laboratory data for the MetSy criteria set forth by the International Diabetes Federation (IDF). The blood pressure, BMI, and waist circumference (WC) were measured, while venous fasting blood was used to assess biochemical markers such as HDL-C, TG, and fasting blood sugar. The microvascular diabetes complications were identified using abdominal ultrasound, fundus ophthalmoscopy, and routine laboratory tests.We quantified and analyzed these variables individually for T1DM and T2DM patients with or without MetSy and compared them in the presence or absence of diabetes microvascular complications. MetSy prevalence was 25.62% (41, n=160) for T1DM and 60.62% (97, n=160) for T2DM, totaling 43.12%. Among T1DM patients with MetSy, the majority were married males, aged 36-49 years, with a BMI of 26.69±2.20 kg/m2 and a WC of 85.12±4.23, and 67.5% (108) patients had diabetes microvascular complications. Comparatively, in T2DM with MetSy, the majority were married females aged 50-59 years with a BMI of 29.79 ± 4.65 kg/m² and a large WC of 93.43±4.49, and 75% (123) patients had diabetes microvascular complications. Overall, this study noted significant p-values for hypertension, elevated TG, low HDL-c, high WC, obesity, female gender in T2DM, and above 36 years of age in both groups with MetSy. Diabetic retinopathy (DR) at 32.4% (p<0.001) was the most prevalent T1DM microvascular complication, followed by nephropathy (30.6%), neuropathy (DN) at 28.1%, and gastroparesis (DG) at 22.3%. Whereas in T2DM, the prevalence of DN was 36.3% (p<0.001), followed by DKD (29.3%), DG (28.9%), and DR (24.9%). Nearly a quarter of T1DM patients had MetSy, with increasing percentages of overweight and obese patients who are more likely to have DR, DKD, or DN. MetSy affects two-thirds of T2DM patients, with married obese females aged 50-59 being more susceptible than males, who are more likely to suffer DN, DKD, or DG. Risk factors that contribute to the MetSy burden in T1DM and T2DM include hypertension, poor glycemic management, low HDL-C, high TG, and a higher BMI or WC. Increasing age, female gender in T2DM, longer diabetes duration, and co-morbid hypertension were independent predictors of microvascular complications. DR, DN, DKD, and gastroparesis are the most prevalent diabetic microvascular sequelae. The clinical management of diabetic patients with healthy lifestyle adaptations, good glycemic control, antihypertensives, and statins will contribute greatly to MetSy prevention.

Background Obesity, specifically abdominal obesity, is a major risk factor for diabetes. A strong association has been marked between diabetes and obesity. Many abdominal obesity indices have been established, including waist circumference (WC), BMI, and a new tool, the visceral adiposity index (VAI). However, very limited research highlights the association of these anthropometric parameters and VAI to the various microvascular complications of diabetes mellitus (DM). The objective of this study is to investigate the association of VAI with microvascular complications such as retinopathy, nephropathy, and neuropathy in type 2DM (T2DM) patients. Methodology Data from Acharya Vinoba Bhave Rural Hospital (AVBRH) was analyzed in this case-control study with a sample size of 250 patients consisting of 125 cases and 125 controls. The cases and controls were age- and gender-matched. BMI and WCwere measured in these patients, and the VAIwas calculated. These anthropometric parameters were then analyzed to estimate their correlation with the microvascular complications of T2DM. Results The mean age of cases in this study was 58.37± 12.08 years and that of controls was 57.61 ± 14.51 years.Anthropometric parameters, namely, BMI, WC, and VAI were raised in cases as compared with controls, and they showed significant statistical relation with diabetes (for BMI,P= 0.003; for WC, P = 0.001 for malesand P = 0.002 for females; and for VAI,P= 0.005). A significant correlation was noted in the high-density lipoprotein (HDL)cholesterol (P= 0.017 for males and P= 0.0004 for females) and triglyceride (TG) levels (P< 0.0001) between cases and controls. On distributing the maleand femalecases in quartiles, it was observed that with increasing quartiles, VAI increased significantly and was associated with an increased risk of microvascular complications such as retinopathy, nephropathy, and neuropathy. When the anthropometric parameters and VAI were compared with the total microvascular complications and the receiver operating characteristic curve studied, VAI had the maximum AUC (AUC for VAI was 0.826, WC was 0.813, and BMI was 0.806). Univariate analysis of the various microvascular complications showed that WC, BMI, HDL, TGs, and glycated hemoglobin (HbA1c) were all significantly correlated to the microvascular complications inT2DM patients. Conclusions As the VAI was significantly raised in T2DM patients and also seen to be significantly associated with microvascular complications, it could be used as a screening tool forT2DM patients.

High levels of oxLDL/β2-GPI complexes might be a consequence of LDL atherogenic modification mediated by oxidative stress. We aimed to determine whether the levels of serum oxLDL/β2-GPI complexes were correlated with diabetic microvascular complications in type 2 diabetes mellitus (T2DM) patients. Levels of oxLDL/β2-GPI complexes, oxLDL, routine lipid/lipoprotein parameters were measured in 100 healthy controls, 128 T2DM patients without any microvascular complications, and 172 T2DM patients with microvascular complications. Spearman's correlation, multivariable linear regression logistic regression analysis, and receiver operating characteristic (ROC) curve were performed. Levels of serum oxLDL/β2-GPI complexes and oxLDL were significantly higher in T2DM patients with microvascular complications (oxLDL/β2-GPI complexes: 1.10 ± 0.18 U/mL; oxLDL: 48.12 ± 7.24 mmol/L) than those in T2DM patients without microvascular complications (oxLDL/β2-GPI complexes: 0.98 ± 0.16 U/mL; oxLDL: 41.45 ± 6.81 mmol/L) and controls (oxLDL/β2-GPI complexes: 0.79 ± 0.15 U/mL; oxLDL: 27.85 ± 5.32 mmol/L). Variables that remained significantly associated with oxLDL/β2-GPI complexes were oxLDL (β = 0.568, P < 0.001), TC (β = 0.312, P = 0.013) and microvascular complications (β = 0.205, P = 0.027), which accounted for 58.3% of the variation of the level of oxLDL/β2-GPI complexes in T2DM patients (R2 = 0.583). Logistic regression analysis demonstrated that elevation of oxLDL/β2-GPI complexes (OR = 3.14, 95% CI: 1.04-9.46, P = 0.042) and oxLDL levels (OR = 3.02, 95% CI: 1.16-7.83, P = 0.023) were independently associated with occurrence of microvascular complications. Cutoff value of oxLDL/β2-GPI for the presence of microvascular complications was 1.05 U/mL, and AUC area of ROC curve was 0.783 (95%CI: 0.713-0.853), yielding a sensitivity of 86.8% and specificity of 64.9%. Elevation of serum oxLDL/β2-GPI complexes was associated with microvascular complications in T2DM patients.

Circulating GPIHBP1 levels and microvascular complications in patients with type 2 diabetes: A cross-sectional study

Background Type 2 diabetes mellitus (T2DM) is a chronic disease with macrovascular and microvascular complications. Nesfatin-1 is a neuropeptide that develops from a more substantial intermediate compound known as nucleobindin 2 (NUCB2). Nesfatin-1 is known to play a role in regulating various physiological processes related to appetite, energy balance, and body weight. The purpose of the current study was to investigate the serum levels of nesfatin-1 in Egyptian patients with type 2 diabetes mellitus (T2DM) in comparison to healthy subjects and to assess the association of serum nesfatin-1 levels with the occurrence of diabetic microvascular complications in those patients. Methods This matched case-control study was conducted on 90 subjects 40-80 years old, with normal hepatic, cardiac, and respiratory functions, and 60 of them had T2DM. The included participants were divided into two groups: group 1, which was the control groupand included 30 healthy subjects, and group 2, which included 60subjects with T2DM. Group 2 was subdivided according to the presence or absence of microvascular complications into group 2a, which included 30 patients having T2DM with no microvascular complications, and group 2b, which included 30 patients having T2DM with one or more microvascular complications. Results T2DM patients had significantly lower serum nesfatin-1 levels (5.07±1.78 versus 9.05±2.1 mmol/L, <0.001) compared to healthy controls. Also, T2DM patients with microvascular complications had lower serum nesfatin-1 levels (4.32±1.72 versus 5.83±1.51 mmol/L, <0.001) compared to T2DM patients without microvascular complications. Serum nesfatin-1 level at a cutoff value of <8.09 mmol/Lcan be a marker for the detection of diabetes mellitus (DM) with the area under the curve (AUC) of 94.3%, 95% sensitivity, 74.3% specificity, 77.9% positive predictive value (PPV), and 65.7% negative predictive value (NPV), and at a cutoff value of <5.87 mmol/Lcan be a marker for the detection of microvascular complications of diabetes mellitus at AUC of 75.5%, 76.7% sensitivity, 67.3% specificity, 77.1% PPV, and 62.9% NPV. Conclusions Serum Nesfatin-1 may play a potential protective role in diabetes mellitus (DM) and its microvascular complications, as it decreases in individuals with diabetes and those with diabetic microvascular complications compared to controls. Additionally, serum Nesfatin-1 levels may have predictive value for the early detection of Type 2 diabetes mellitus (T2DM) patients, diabetic microvascular complications, and diabetic kidney disease (DKD) at cut-off values of < 8.09 (mmol/L), < 5.87 (mmol/L), and < 5.46 (mmol/L), respectively. Therefore, targeted Nesfatin-1 drug therapy may be tried to reduce morbidity and mortality caused by microvascular complications of diabetes.

Objective: To explore the relationship between serum 1, 5-dehydratoglucitol (1, 5-AG) level and insulin resistance, microvascular complications in patients with type 2 diabetes mellitus (T2DM). Methods: The clinical data of 836 patients with T2DM admitted to the Changsha Central Hospital Affiliated to University of South China from May to December 2023 were retrospectively and cross-sectionally analyzed. Serum 1, 5-AG levels were detected by pyranose oxidase method. According to the microvascular complications (diabetic peripheral neuropathy, diabetic nephropathy, diabetic retinopathy), the patients were divided into simple group (no microvascular complications, n=490), complication group 1 (1 microvascular complications, n=217), and complication group 2 (2 or more microvascular complications, n=129). The relationship between serum 1, 5-AG level and the related indicators of insulin resistance in T2DM patients were explored by Spearman correlation analysis, and the influencing factors of microvascular complications in T2DM patients were explored by multiple ordered logistic regression analysis. Results: The levels of FBG(fasting blood glucose) [(7.37±0.56) mmol/L], FINS(fasting insulin) [(11.34±1.86) mU/L] and HOMA-IR(homeostatic model assessment of insulin resistance) (0.96±0.31) in simple group were lower than those in complication group 1 [(8.37±1.02) mmol/L, (16.26±2.32) mU/L, (1.32±0.41)], complication group 2 [(10.25±2.13) mmol/L, (18.53±2.67) mU/L, (1.54±0.44)], and FBG, FINS and HOMA-IR in complication group 1 were lower than those in complication group 2, and the differences were statistically significant (F=537.470, 791.690, 136.340, P<0.001). Serum 1, 5-AG level in simple group [77.16 (16.30, 128.07) μg/ml] was higher than that in complication group 1 [51.05 (14.67, 63.18) μg/ml] and complication group 2 [30.42 (12.53, 47.26) μg/ml], and the serum level of 1, 5-AG in complication group 1 was higher than that in complication group 2, and the difference was statistically significant (H=210.020, P<0.001). The results of Spearman correlation analysis showed that serum 1, 5-AG level was negatively correlated with FBG, FINS and HOMA-IR in T2DM patients (r=-0.431, -0.372, -0.546, P<0.001). The results of multiple ordered logistic regression analysis showed that Longer duration of diabetes (OR=2.261, 95%CI: 1.564-3.269), increased HbA1c (OR=2.040, 95%CI: 1.456-2.858), and increased HOMA-IR (OR=2.158, 95%CI: 1.484-3.137) and decreased 1, 5-AG (OR=2.512, 95%CI: 1.691-3.732) were independent risk factors for microvascular complications in T2DM patients (P<0.05). The results of ROC curve analysis showed that the area under the curve of serum 1, 5-AG in the identification of one microvascular complication was 0.763 (95%CI: 0.731-0.795), and the area under the curve of serum 1, 5-AG in the identification of two or more microvascular complications was 0.730 (95%CI: 0.692-0.767). Conclusion: Serum 1, 5-AG level is negatively correlated with insulin resistance in T2DM patients. Low serum 1, 5-AG level may be an independent risk factor for microvascular complications in T2DM patients.

To investigate the association between various obesity indices and the risk of developing microvascular complications in adult patients with Type 2 diabetes(T2DM), using cohort data derived from Yinzhou District Health Big Data Platform of China. This study included adult patients with type 2 diabetes(T2DM) who were enrolled between January 1, 2008, and December 31, 2013, in Yinzhou District, Ningbo, and did not have any microvascular complications at baseline. Data collection encompassed demographic characteristics, lifestyle behaviors, laboratory test result, and physical examination findings, obtained at both baseline and during follow-up periods through structured epidemiological surveys and clinical assessments. Various obesity indices were calculated, including body mass index(BMI), waist-to-height ratio(WHtR), a body shape index(ABSI) and body roundness index(BRI). We also computed the coefficients of variation for these obesity indices during the follow-up period. A Cox proportional hazards regression model was used to analyze the association between obesity indices at baseline and follow-up, and the risk of developing microvascular complications. Additionally, receiver operating characteristic(ROC) curves were used to analyze the predictive efficacy of the coefficients of variation for BMI, WHtR, ABSI and BRI in relation to microvascular complications, and the areas under the curve(AUCs) were calculated. A total of 27 635 patients with type 2 diabetes(T2DM) were included, contributing to 153 717 person-years of follow-up. During this period, 12 969 new cases of microvascular complications were identified, resultsing in an incidence rate of 84.37 cases per 1000 person-years. Patients were categorized into two groups based on the occurrence of complications: those with microvascular complications and those without. There was no significant difference in blood glucose levels between the two groups at baseline. After adjusting for sociodemographic characteristics, laboratory indicators, and potential confounders such as a history of hypertension and hyperlipidemia, it was found that only the WHtR(HR=1.027, 95%CI 1.008-1.046), ABSI(HR=1.035, 95%CI 1.018-1.053) and BRI(HR=1.030, 95%CI 1.011-1.049) were independently associated with the risk of microvascular complications at baseline, while waist circumference(HR=1.010, 95%CI 0.992-1.029) and BMI(HR=0.985, 95%CI 0.967-1.002) were not significantly related(P&gt;0.05). During the follow-up period, the coefficients of variation for all obesity indices were independently associated with an increased risk of microvascular complications. Among them, abdominal obesity indices, such as waist circumference(HR=0.063, 95%CI 1.057-1.069), WHtR(HR=1.060, 95%CI 1.054-1.066), and ABSI(HR=1.062, 95%CI 1.058-1.066), were most strongly linked to the risk of microvascular complications. Further stratified analysis based on baseline BMI revealed that the variability in abdominal obesity indices was more strongly associated with microvascular complications in patients with normal and overweight BMI compared to those with obesity. Specifically, the following result were observed: waist circumference(HR_(normal BMI)=1.074, HR_(overweight)=1.059, HR_(obesity)=1.041; P&lt;0.01), WHtR(HR_(normal BMI)=1.069, HR_(overweight)=1.059, HR_(obesity)=1.037; P&lt;0.01), ABSI(HR_(normal BMI)=1.065, HR_(overweight)=1.067, HR_(obesity)=1.038; P&lt;0.01), BRI(HR_(normal BMI)=1.023, HR_(overweight)=1.020, HR_(obesity)=1.011; P&lt;0.01). Additionally, to further explore the predictive value of various obesity indices for microvascular complications in type 2 diabetes mellitus(T2DM), we conducted stratified analyses based on sex and age(using 60 years as the cutoff). WHtR showed similar predictive performance between men(AUC = 0.794) and women(AUC=0.789). However, WHtR demonstrated stronger predictive ability in individuals over 60 years old(AUC = 0.803) compared to those aged 60 years or younger(AUC = 0.777). ABSI exhibited a higher predictive value in men(AUC = 0.752) than in women(AUC = 0.730), and again, the index performed better in the older population(AUC = 0.761) than in the younger group(AUC = 0.725). Similarly, BRI demonstrated comparable performance between sexes [men(AUC = 0.796) and women(AUC = 0.791)] with the highest predictive accuracy seen in participants over 60 years(AUC = 0.806). By contrast, BMI showed relatively lower predictive power across all subgroups. Specifically, the AUC values for BMI were 0.744 in men and 0.714 in women, 0.714 in those aged 60 years or below and 0.748 in those above 60 years. Increased baseline abdominal obesity indices(WHtR, ABSI and BRI) and higher variability in obesity indices during follow-up are strongly associated with increased risks of microvascular complications in T2DM patients. In individuals with normal BMI, higher variability in abdominal obesity indices is positively correlated with the risk of microvascular complications. Furthermore, the variability in abdominal obesity indices(WHtR, ABSI and BRI) provides better predictive ability for microvascular complications compared to general obesity indices(BMI), especially in male patients and those aged over 60.

Type-2 Diabetes Mellitus (T2DM) is associated with a greater amount of morbidity and mortality due to microvascular and macrovascular complications. Involvement of platelets in vascular complications of diabetes is well known and changes in platelet indices have been identified as predictors of these vascular complications. This study was carried out to determine the changes in platelet indices in patients with T2DM. This was a comparative cross sectional study conducted at Teaching Hospital, Karapitiya. Study subjects included T2DM patients with microvascular complications as study group and T2DM patients without any vascular compli-cations as comparison group. For each group age and sex matched 52 subjects were recruited. Subjects with microvascular complications had mean platelet volume (MPV) of 10.62±0.49fL, platelet distribution width (PDW) of 12.23±1.12fL, plateletcrit (PCT) of 0.28±0.05% and platelet large cell ratio (PLCR) of 29.44±4. Subjects without any vascular complications had MPV of 9.38±0.40fL, PDW of 9.9±1.14fL, PCT of 0.26±0.05% and PLCR of 19.67±3.1. Values of MPV, PDW and PLCR were significantly higher in patients with diabetic microvascular complications (p&lt;.001). There was no significant difference in PCT between the two groups. In comparison of platelet indices according to glycemic control, a significantly higher MPV, PDW and PLCR values were observed in patients with HbA1c of &gt;7% (p&lt;.001). A significant association was present among the MPV, PDW and PLCR values when fasting plasma glucose (FPG) was &gt; 130mg/dL (p&lt;.001). There was a direct relation-ship with abnormal platelet indices and microvas-cular complications of T2DM. Further studies are recommended to ascertain causative relationship of changes in platelet indices and diabetic microvascular complications.

Type 2 diabetes mellitus (T2DM) is a chronic condition associated with various microvascular complications, including neuropathy, retinopathy, and nephropathy. Recent studies have suggested a potential association between serum omentin levels and the risk of developing microvascular complications in patients with T2DM. However, the existing evidence remains inconclusive. Therefore, we conducted a systematic review and meta-analysis to examine the association between serum omentin levels and microvascular complications in T2DM patients. A comprehensive search was conducted in PubMed, Scopus, and Google Scholar databases to retrieve relevant articles published up to May 2023. Observational studies investigating omentin levels association with microvascular complications in T2DM patients were included. Data was extracted and hence analyzed. A total of seven cross-sectional articles met the inclusion criteria, with a total population of 1587 participants. The meta-analysis revealed a significant association between serum omentin levels and microvascular complications in patients with T2DM. Serum omentin levels were lower in patients with microvascular complications than in those without complications (Mean difference, 95% confidence interval: -1.31 [-2.50, -0.13], I2 = 99.62%). This systematic review and meta-analysis provides evidence supporting an association between serum omentin levels and microvascular complications in patients with T2DM. The findings suggest that Omentin may be lower in T2DM patients with microvascular complications. Further research is warranted to elucidate the underlying mechanisms and explore the clinical implications of these findings. The online version contains supplementary material available at 10.1007/s40200-023-01359-2.

Background: Type 2 Diabetes mellitus (T2DM) may affect the musculoskeletal (MSK) system in a variety of ways. The impacts can be debilitating enough to impair functional ability and quality of life. MSK complications are the most common endocrine arthropathies which are often under-recognized and poorly treated. This study was done to evaluate the prevalence of MSK complications and its correlation with microvascular complications of T2DM given the paucity of similar studies in India particularly South India. Materials and Methods: A cross-sectional study was conducted on 130 diabetic patients at a tertiary care hospital in Bengaluru. The patient’s demographic details, clinical profile including history, general physical examination, systemic examination, and relevant investigations were done to record microvascular complications. A thorough MSK system examination along with imaging of bones and joints was also performed. Results: Out of 130 diabetic patients, 21 patients (16.2%) had MSK complications of which 47.6% (n = 10) of them had carpal tunnel syndrome and 42.8% (n = 9) had frozen shoulder and 9.5% (n = 2) had diabetic amyotrophy. It was also noted that patients who were on oral hypoglycemic agents alone were more likely to develop MSK complications (57.14%) than patients solely on insulin (14.2%). Poor glycemic control, existing microvascular complications, and low high-density lipoprotein were found to be associated with increased risk of MSK complications. Conclusion: The prevalence of MSK complications in T2DM patients is quite significant and is also associated with microvascular complications. Improved glycemic control in T2DM was found to reduce the burden of such complications. Early identification of MSK complications can improve the quality of life in diabetic patients and hence demands proper screening and follow-up.

Subclinical left ventricular (LV) dysfunction is prevalent in type 2 diabetes (T2DM). As obesity has been proposed as one causal factor in the disease process, this could bias the reported prevalences. We wanted to characterize echocardiographic LV dysfunction in obese T2DM subjects as compared to non-diabetic obese controls. One hundred patients with T2DM without clinical signs of heart failure (29% females, mean ± SD age 58.4 ± 10.5 years, body mass index (BMI) 30.1 ± 5.5 kg/m(2), blood pressure (BP) 141 ± 18/83 ± 9 mmHg) and 100 non-diabetic controls (29% females) matched for age (58.6 ± 10.5 years), BMI (29.8 ± 4.0 kg/m(2) and systolic BP (140 ± 14 mmHg) underwent echocardiography and color tissue Doppler imaging (TDI). Diastolic function was evaluated with conventional Doppler recordings and early (e') and late (a') myocardial velocities. The ratio between early transmitral filling (E) and the corresponding myocardial tissue velocity (e') served as an index of LV filling pressure. T2DM patients had more concentric hypertrophy with a relative wall thickness of 0.42 ± 0.07 vs controls 0.38 ± 0.07, P < 0.001. The T2DM group had signs of diastolic dysfunction with lower E/A ratio (0.91 ± 0.27 vs. 1.12 ± 0.38, P < 0.001), deceleration time (195 ± 49 vs 242 ± 72 ms, P < 0.001), e' (5.7 ± 2.0 vs. 6.6 ± 1.8 cm/s, P = 0.001), and a' (6.5 ± 2.0 vs. 7.6 ± 1.5 cm/s, P < 0.001) compared to the controls, and higher E/e' (13.3 ± 4.7 vs. 11.1 ± 3.5, P < 0.001). Thus, there were indications of pseudo normalization and increased filling pressure in the T2DM group, whereas the controls had evidence for relaxation abnormalities without elevated filling pressure. Compared to a non-diabetic obese group, more advanced subclinical impairment of diastolic function was seen in T2DM.

Objective. The present study was directed to assess the correlation between leukocyte and platelet indices and microvascular complications in patients with type 2 diabetes mellitus (T2DM). Methods. A prospective cross-sectional study was conducted between January 2020 and May 2021 at a tertiary healthcare center. Sixty T2DM patients, who fulfilled the inclusion and exclusion criteria, were included into the study and divided into 2 groups: T2DM patients with microvascular complications and T2DM patients without vascular complications. Clinical history was taken and examinations (routine complete blood count) were done to obtain platelet indices, neutrophillymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) were obtained and tabulated. A correlation was statistically analyzed from the obtained data, p value <0.05 was considered to be statistically significant. Results. From the patients with microvascular complications, 18 cases suffered from retinopathy and nephropathy. Majority of the participants suffered from moderate non-proliferative retinopathy. The creatine median and absolute neutrophil count (ANC) were significantly higher in T2DM patients with microvascular complications (p<0.0001 and p<0.0054, respectively) compared to T2DM patients without vascular complications. No significant correlation was found between platelet indices, NLR, PLR with regard to fasting blood sugar, post prandial blood sugar, HbA1C in T2DM patients. Conclusions. Since no significant correlation was found between the different platelet indices and microvascular complications, it is evident that these markers cannot be used as the predictors of microvascular complications in T2DM patients.

BackgroundVascular endothelial growth factor (VEGF) is a signal protein, induces cell proliferation, and enhances the permeability of the endothelial cells. VEGF-A gene is highly polymorphic, with different near-gene variants at varied frequencies linked with altered VEGF protein expression, type 2 diabetes mellitus (T2DM) susceptibility, and associated microvascular complications. The present study aimed to investigate the role of two genetic variants of VEGF-A, − 583C > T (rs3025020) and + 936 C/T (rs3025039), for predicting mixed microvascular complications in T2DM. This case–control study was performed on 26 T2DM patients with mixed microvascular complications and 26 apparently healthy individuals, as a control group. Clinical, neurological, funds examinations, and biochemical laboratory investigations were conducted on all groups. The serum level of VEGF-A was measured using ELISA. Genotyping of VEGF-A was performed by real-time PCR allelic discrimination system.ResultsSerum level of VEGF-A was significantly increased in T2DM with mixed complications. T allele of VEGF-A rs3025020 showed higher frequency among T2DM patients with mixed complications than in control group [OR 2.67; 95% CI 1.03–6.91; p = 0.04], while CT genotype and T allele of VEGF-A rs3025039 had a high frequency in mixed complication group [OR 4.08; 95% CI 1.32–17.44; p = 0.01 and OR 4.02; 95% CI 1.52–10.63; p = 0.004, respectively].ConclusionVEGF-A increased the level contributed in the pathogenesis of mixed diabetic microvascular complications. T allele of VEGF-A rs3025020, CT genotype, and T allele of VEGF-A rs3025039 had the highest frequency in mixed diabetic microvascular complications, so they were considered risk genes for mixed diabetic microvascular complications.

Hamilton rating scale for depression-24 (HAM-D24) as a novel predictor for diabetic microvascular complications in type 2 diabetes mellitus patients

Microvascular complications are prevalent in patients with type 2 diabetes mellitus (T2DM), resulting in increased risk of cardiovascular mortality. However, it is unclear whether above-knee artery calcification relates to microvascular complications. This study was aimed to investigate the role of calcification in superficial femoral arteries (SFA), the major above-knee artery, compared with anterior tibial arteries (ATA) and posterior tibial arteries (PTA), in T2DM-related microvascular complications and explore its risk factors. A single-center and observational study involving 359 T2DM patients was conducted. Clinical and laboratory data were collected. SFA calcification was evaluated by ultrasonography. Compared with ATA and PTA calcification, operating characteristics curve analysis showed that SFA calcification was the strongest predictor (63.1% sensitivity and 69.2% specificity) for T2DM-related microvascular complications (diabetic neuropathy, diabetic nephropathy and diabetic retinopathy). With the severity of SFA calcification increased, age, duration of T2DM, and SBP were significantly elevated, but triglyceride and glucose index and estimated glomerular filtration rate (eGFR) were significantly reduced (all P < 0.05). Multivariate logistic analysis showed that eGFR (OR 0.953; 95% CI 0.931–0.976; P < 0.001) was an independent risk factor of SFA calcification, especially in young patients with HbA1c > 7.0. We identified SFA calcification as a good predictor of microvascular complications in T2DM patients. Reduced eGFR was significantly associated with increased SFA calcification prevalence, especially in young T2DM patients with bad controlled hyperglycemia.