SIGNIFICANCE OF METABOLIC AND BLOOD-PRESSURE FACTORS IN RELATION TO MICROANGIOPATHY AND MACROANGIOPATHY IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

We are actively seeking methods to prevent and to limit the progressio n of angiopathy in patients with non-insulin-dependent diabetes mellit us (NIDDM). In the present study, we conducted a clinical and epidemio logical survey to clarify the clinical factors responsible for the dev elopment and progression of diabetic microangiopathy (MI) and macroang iopathy (MA). A total of 107 patients (58 female and 49 male) were ran domly selected from 145 NIDDM patients. Twenty-four patient variables were selected for analysis. We identified PWV, UAI, RETINOP, MCV-T, SC V-S, MCV-P, SEP, and DBP as responsible factors and carried out stepwi se multiple regression analyses. The following explanatory variables w ere found to be significant: age > SCV-S (P < 0.0001) for the criterio n variable PWV, BUN > HbA(1C) > MCV-P > HT-drug > HDL-C (P < 0.0001) f or log(e) UAI, DM-thera > SBP (P < 0.0001) for RETINOP, MCV-P (P < 0.0 001) for MCV-T, IRI > SEP > MCV-P > S-CR (P < 0.0002) for SCV-S, MCV-T > SCV-S > DM-thera (P < 0.0001) for MCV-P, DBP > HT-drug > BUN > MCV- P (P < 0.0001) for SBP, and SBP > PWV > sex (P < 0.0001) for DBP, In s ummary, responsible factors for MI and MA in NIDDM had metabolic and b lood pressure factors in common, Moreover, MI was a responsible factor for MA, which becomes a responsible factor for MI because it is a res ponsible factor for blood pressure factors, Thus, all the responsible factors for MA represented by MI and PWV had metabolic and blood press ure factors in common, The results of this study suggest that metaboli c and blood pressure factors must be controlled to prevent and to limi t the progression of diabetic MI and MA in NIDDM patients.