Inflammatory Markers Used as Predictors of Subclinical Atherosclerosis in Patients with Diabetic Polyneuropathy.

Autor: Mureșan AV; Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania.; Department of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania., Tomac A; Clinic of Plastic Surgery, Emergency Clinical Hospital Saint Spiridon, 700111 Iasi, Romania., Opriș DR; Emergency Institute for Cardiovascular Diseases and Transplantation (IUBCVT) of Targu Mures, 540136 Targu Mures, Romania., Bandici BC; Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania., Coșarcă CM; Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania.; Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania., Covalcic DC; Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania., Hălmaciu I; Department of Radiology, Mures County Emergency Hospital, 540136 Targu Mures, Romania., Akácsos-Szász OZ; Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania., Rădulescu F; Clinical Department of Endocrinology, Mures County Emergency Hospital, 540136 Targu Mures, Romania.; Department of Scientific Research Methodology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania., Lázár K; Clinical Department of Endocrinology, Mures County Emergency Hospital, 540136 Targu Mures, Romania., Stoian A; Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania., Tilinca MC; Department of Diabetes, Nutrition and Metabolic Diseases, Mures County Emergency Hospital, 540136 Targu Mures, Romania.; Department of Internal Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania.
Jazyk: angličtina
Zdroj: Life (Basel, Switzerland) [Life (Basel)] 2023 Sep 03; Vol. 13 (9). Date of Electronic Publication: 2023 Sep 03.
DOI: 10.3390/life13091861
Abstrakt: Background: peripheral arterial disease (PAD) is identified late in diabetic patients because, in the majority of cases, it is associated with diabetic peripheral neuropathy, resulting in little or no symptoms, or symptoms that are completely neglected.
Methods: In this study were enrolled all patients over 18 years of age, with diabetes mellitus type II for more than a year with poor glycemic control, diagnosed with diabetic polyneuropathy admitted to the Diabetology Department, Emergency County Hospital of Targu Mures, Romania between January 2020 and March 2023. We divided the patients into two groups, based on the presence or absence of subclinical atherosclerosis in the lower limb, named "SA" and "non-SA".
Results: Patients in the SA group were older ( p = 0.01) and had a higher incidence of IHD ( p = 0.03), history of MI ( p = 0.02), and diabetic nephropathy ( p = 0.01). Moreover, patients with subclinical atherosclerosis had a higher BMI ( p < 0.0001) and a longer duration of diabetes ( p < 0.0001). Among all patients, the systemic inflammatory markers, MLR (r = 0.331, p < 0.001), NLR (r = 0.517, p < 0.001), PLR (r = 0.296, p < 0.001), SII (r = 0.413, p < 0.001), as well as BMI (r = 0.241, p < 0.001) and HbA1C (r = 0.489, p < 0.001), demonstrated a strong positive correlation with the diabetes duration. The multivariate logistic regression analysis showed that older patients (OR: 2.58, p < 0.001), the male gender (OR: 2.30, p = 0.006), a higher baseline levels of BMI (OR: 7.71, p < 0.001), and the duration of diabetes (OR: 8.65, p < 0.001) are predictors of subclinical atherosclerosis in DN patients. Additionally, the high baseline levels of all systemic inflammatory markers (for all: p < 0.001) and poor diabetes management (OR: 10.4, p < 0.001 for HbA1C; OR: 10.78, p < 0.001 for admission glucose) are independent predictors of SA.
Conclusions: the inflammatory markers, NLR, MLR, PLR, and SII, being cheap and easy to collect in routine medical practice from the standard blood tests, could be an important step in predicting vascular outcomes in diabetic patients and the disease's progression, playing a key role in follow-up visits in type-2 diabetic patients and PAD patients.
Databáze: MEDLINE
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