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Association between microcirculatory indicators and microvascular complications in patients with type 2 diabetes mellitus

diabetes-and-endocrinology
endocrinology
diabetes

Abstract

Objective: To investigate the association between microcirculatory indicators and diabetic microvascular complications (DMC), and to provide evidence for the evaluation of microcirculatory dysfunction–related microvascular complications in patients with diabetes mellitus. Methods :A total of 596 patients with type 2 diabetes mellitus (T2DM) were recruited from the Department of Endocrinology of a hospital in Anhui Province, China.Microcirculatory function was assessed using laser Doppler flowmetry, with perfusion units percentage (PU%) as the primary indicator. The prevalence trends of DMC across different PU% levels were analyzed. Multivariable logistic regression analysis was performed to evaluate the independent association between PU% and DMC. Results :(1) The prevalence of diabetic retinopathy (DR) increased significantly when PU% decreased below 350–399 (39% vs. 61%). The prevalence of diabetic kidney disease (DKD) and diabetic peripheral neuropathy (DPN) increased markedly when PU% decreased below 300–349 (DKD: 23% vs. 48%; DPN: 39% vs. 71%). Receiver operating characteristic (ROC) curve analysis indicated that a PU% < 300 could serve as an optimal cutoff value for DMC screening. (2) Multivariable logistic regression analysis demonstrated that PU% categories were independently associated with DR, DKD, and DPN. Compared with patients in the high PU% group (≥300), those in the low PU% group (<300) had significantly increased risks of DR, DKD, and DPN, with odds ratios of 1.98, 2.61, and 3.52, respectively. Conclusion :Reduced PU% is significantly associated with an increased risk of microvascular complications in patients with T2DM and represents an independent risk factor for DR, DKD, and DPN. PU% may serve as a quantitative indicator reflecting microcirculatory impairment in T2DM and provides valuable reference for mechanistic studies and early assessment of diabetic microvascular complications.
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