1.A Study on the Influencing Factors of Microcirculatory Dysfunction in Elderly Patients with Type 2 Diabetes Mellitus
Peiyi ZHAO ; Xinda CHEN ; Sijia FEI ; Qi PAN
Chinese Journal of Geriatrics 2025;44(4):421-428
Objective:This study used non-invasive diagnostic techniques to assess microcirculatory dysfunction in the lower extremities, investigate its influencing factors in elderly patients with type 2 diabetes, and explore its correlation with diabetic microvascular complications.Methods:A total of 417 elderly patients with type 2 diabetes mellitus(T2DM)hospitalized in the Department of Endocrinology at Beijing Hospital between March 2024 and January 2025 were retrospectively enrolled.Based on transcutaneous oxygen pressure(TcPO2)and/or temperature-controlled laser Doppler flowmetry(LDF)blood flow changes in the lower limbs, participants were categorized into a microcirculatory dysfunction group(290 cases, 69.54%)and a normal microcirculation group(127 cases, 30.46%).Statistical analyses, including independent samples t-tests, Mann-Whitney U tests, and χ2 tests, were applied to compare intergroup differences.Multivariate stepwise logistic regression was conducted to identify risk factors for microcirculatory dysfunction. Results:After adjusting for confounding factors, multivariate regression analysis revealed female sex as a protective factor for microcirculation dysfunction( OR=0.456, 95% CI: 0.291-0.715, P<0.001).Gender-stratified analysis further demonstrated indicated that in elderly male T2DM patients, diabetes duration( OR=1.075, 95% CI: 1.024-1.128, P=0.004), hemoglobin A 1c( OR=1.346, 95% CI: 1.101-1.645, P=0.004), body mass index( OR=1.244, 95% CI: 1.095-1.412, P<0.001)and clinically diagnosed diabetic peripheral neuropathy( OR=2.576, 95% CI: 1.181-5.619, P=0.017)were significant risk factors for microcirculatory dysfunction.In elderly female T2DM patients, clinically diagnosed diabetic peripheral neuropathy( OR=2.869, 95% CI: 1.480-5.562, P=0.002), abnormal nerve conduction study( OR=2.023, 95% CI: 1.080-3.790, P=0.028), and diabetic nephropathy( OR=2.451, 95% CI: 1.130-5.317, P=0.023)were identified as significant risk factors. Conclusions:Significant gender disparities exist in microcirculatory dysfunction among elderly T2DM patients.Male patients exhibit a higher prevalence of lower limb microcirculatory impairment, highlighting the need for intensified management of cardiovascular risk factors.In contrast, female patients face elevated risks of microvascular complications, emphasizing the importance of early screening for microcirculatory dysfunction and related microvascular pathologies.
2.A Study on the Influencing Factors of Microcirculatory Dysfunction in Elderly Patients with Type 2 Diabetes Mellitus
Peiyi ZHAO ; Xinda CHEN ; Sijia FEI ; Qi PAN
Chinese Journal of Geriatrics 2025;44(4):421-428
Objective:This study used non-invasive diagnostic techniques to assess microcirculatory dysfunction in the lower extremities, investigate its influencing factors in elderly patients with type 2 diabetes, and explore its correlation with diabetic microvascular complications.Methods:A total of 417 elderly patients with type 2 diabetes mellitus(T2DM)hospitalized in the Department of Endocrinology at Beijing Hospital between March 2024 and January 2025 were retrospectively enrolled.Based on transcutaneous oxygen pressure(TcPO2)and/or temperature-controlled laser Doppler flowmetry(LDF)blood flow changes in the lower limbs, participants were categorized into a microcirculatory dysfunction group(290 cases, 69.54%)and a normal microcirculation group(127 cases, 30.46%).Statistical analyses, including independent samples t-tests, Mann-Whitney U tests, and χ2 tests, were applied to compare intergroup differences.Multivariate stepwise logistic regression was conducted to identify risk factors for microcirculatory dysfunction. Results:After adjusting for confounding factors, multivariate regression analysis revealed female sex as a protective factor for microcirculation dysfunction( OR=0.456, 95% CI: 0.291-0.715, P<0.001).Gender-stratified analysis further demonstrated indicated that in elderly male T2DM patients, diabetes duration( OR=1.075, 95% CI: 1.024-1.128, P=0.004), hemoglobin A 1c( OR=1.346, 95% CI: 1.101-1.645, P=0.004), body mass index( OR=1.244, 95% CI: 1.095-1.412, P<0.001)and clinically diagnosed diabetic peripheral neuropathy( OR=2.576, 95% CI: 1.181-5.619, P=0.017)were significant risk factors for microcirculatory dysfunction.In elderly female T2DM patients, clinically diagnosed diabetic peripheral neuropathy( OR=2.869, 95% CI: 1.480-5.562, P=0.002), abnormal nerve conduction study( OR=2.023, 95% CI: 1.080-3.790, P=0.028), and diabetic nephropathy( OR=2.451, 95% CI: 1.130-5.317, P=0.023)were identified as significant risk factors. Conclusions:Significant gender disparities exist in microcirculatory dysfunction among elderly T2DM patients.Male patients exhibit a higher prevalence of lower limb microcirculatory impairment, highlighting the need for intensified management of cardiovascular risk factors.In contrast, female patients face elevated risks of microvascular complications, emphasizing the importance of early screening for microcirculatory dysfunction and related microvascular pathologies.
3.Effects of aging on air-conducted sound elicited ocular vestibular-evoked myogenic potential and cervical vestibular-evoked myogenic potential
Qing ZHANG ; Xinda XU ; Xiaorong NIU ; Juan HU ; Yanfei CHEN ; Min XU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2014;49(11):897-901
Objective To identify the aging effects on air-conducted sound (ACS) elicited ocular vestibular-evoked myogenic potential (oVEMP) and cervical vestibular-evoked myogenic potential (cVEMP) in normal Chinese population.Methods Nighty-seven normal subjects (194 ears) were recruited for conventional ACS-oVEMP and ACS-cVEMP examinations.The candidates'age were 4-83 years old (Ave.± SD,45.7 ± 19.3),41 male and 56 female,divided into 5 groups according to age.500 Hz short tone burst was employed for examinations.Thresholds were identified and the parameters of the responses to 100dB nHL were calculated and compared among groups.SPSS 13.0 software was used to analyze the date.Results As the age growing,the response rate for oVEMP decreased.It was recorded 100% in both ≤ 10-year-old and 11-30-year-old groups,84.00% in the 31-50-year-old group,48.15% in the 51-70-year-old group and 15.00% in the >70-year-old group; while that for cVEMP were 100% in both-≤10-year-old group and 11-30-year-old group,82.00% in the 31-50-year-old group,77.78% in the 51-70-year-old group and 45.00% in the > 70-year-old group.The thresholds elevated and the amplitudes decreased in both examinations with the age growing.However,latencies and latency-intervals of both oVEMP and cVEMP examinations displayed minor difference among groups except that nI latency of oVEMP prolonged with age growing.Conclusions With the age growing,the otolithic end organ input pathways degenerate in normal subjects,as shown that ACS elicited oVEMP and cVEMP responsed less with higher threshold and smaller amplitude.The extremely low response rates of both VEMPs in the >70-year-old group in this study indicates that VEMPs can only provide limited diagnostic information among very old people in clinical practice.

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