The Impact of Glycemic Control on Post-Intervention Coagulation Function and Recurrence Risk in Patients with Diabetic Lower Extremity Arteriosclerosis Obliterans

doi:10.3877/cma.j.issn.2095-5782.2026.01.003

Abstract

Abstract:

Objective

To analyze the impact of glycemic control levels on post-interventional coagulation function and the risk of post-procedure recurrence in patients with diabetes-induced lower extremity arteriosclerosis obliterans (DLASO) on the coagulation function after vascular interventional therapy and the risk of postoperative recurrence.

Methods

A total of 124 patients with DLASO treated from October 2021 to October 2024 were enrolled. Patients were divided into a recurrence group (n=46) and a non-recurrence group (n=78) based on clinical outcomes. Baseline data and post-procedure coagulation function indices were compared. Pearson correlation was used to analyze the relationship between blood glucose levels and coagulation function. Risk factors for recurrence were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) and multivariate logistic regression. The dose-response relationship between coagulation function and recurrence was assessed via restricted cubic splines (RCS). A mediation effect model was employed to evaluate the mediating role of coagulation function in the relationship between glycemic control and recurrence.

Results

The recurrence group had significantly higher proportions of patients with HbA1c ≥7.0% and FIB >4 g/L, as well as higher levels of blood lipids, hemorheology indices, VEGF, and endothelin-1, while PT, APTT, and TT levels were significantly lower compared to the non-recurrence group (P<0.05). Post-procedure PT, APTT, and TT at one week were negatively correlated with HbA1c levels (P<0.05). Multivariate analysis identified one-week post-procedure HbA1c, FIB, VEGF, and APTT as independent influencing factors for recurrence (P<0.05). There was a nonlinear dose-response relationship between one-week post-procedure PT, APTT, TT and recurrence (P<0.05). Coagulation function indicators at one week post-procedure mediated the relationship between HbA1c levels and recurrence (P<0.05).

Conclusion

Blood glucose control level is correlated with coagulation function, and both are independent influencing factors for recurrence after endovascular intervention in DLASO patients. These findings provide a reference for the early clinical identification of patients at high risk of recurrence.

Key words: Diabetes, Lower limb arterial occlusive disease, Vascular intervention therapy, Coagulation function, Post-procedure recurrence

Jinjie Zhao, Wei Zhong, Guoxue Zheng. The Impact of Glycemic Control on Post-Intervention Coagulation Function and Recurrence Risk in Patients with Diabetic Lower Extremity Arteriosclerosis Obliterans[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2026, 14(01): 20-25.

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References 18

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临床资料	复发组(n=46)	未复发组(n=78)	t /χ²值	P值
性别[例(%)]			0.357	0.550
男	24(52.17)	45(57.69)
女	22(47.83)	33(42.31)
年龄[例(%)]			2.294	0.130
<65岁	21(45.65)	25(32.05)
≥65岁	25(54.35)	53(67.95)
HbA1c[例(%)]			29.121	<0.001
<7.0%	10(21.74)	56(71.79)
≥7.0%	36(78.26)	22(28.21)
TC(mmol/L)	5.36±1.49	4.53±1.40	3.114	0.002
TG(mmol/L)	1.98±0.72	1.54±0.43	4.265	<0.001
FIB[例(%)]			11.877	0.001
>4 g/L	30(65.22)	26(33.33)
≤4 g/L	16(34.78)	52(66.67)
血浆黏度(mPa/s)	2.98±0.76	2.12±0.47	7.792	<0.001
全血黏度高切(mPa/s)	8.55±1.23	7.46±1.11	5.073	<0.001
全血黏度低切(mPa/s)	11.62±1.38	11.17±1.21	1.898	0.060
VEGF(ng/mL)	212.32±63.21	188.68±54.79	2.191	0.030
ET-1(ng/L)	86.47±8.52	82.26±7.56	2.857	0.005
PT(s)	12.19±1.20	14.23±1.37	8.378	<0.001
APTT(s)	33.87±6.45	36.35±5.61	2.248	0.026
TT(s)	20.02±2.18	23.14±2.66	6.730	<0.001

临床资料	复发组(n=46)	未复发组(n=78)	t /χ²值	P值
性别[例(%)]			0.357	0.550
男	24(52.17)	45(57.69)
女	22(47.83)	33(42.31)
年龄[例(%)]			2.294	0.130
<65岁	21(45.65)	25(32.05)
≥65岁	25(54.35)	53(67.95)
HbA1c[例(%)]			29.121	<0.001
<7.0%	10(21.74)	56(71.79)
≥7.0%	36(78.26)	22(28.21)
TC(mmol/L)	5.36±1.49	4.53±1.40	3.114	0.002
TG(mmol/L)	1.98±0.72	1.54±0.43	4.265	<0.001
FIB[例(%)]			11.877	0.001
>4 g/L	30(65.22)	26(33.33)
≤4 g/L	16(34.78)	52(66.67)
血浆黏度(mPa/s)	2.98±0.76	2.12±0.47	7.792	<0.001
全血黏度高切(mPa/s)	8.55±1.23	7.46±1.11	5.073	<0.001
全血黏度低切(mPa/s)	11.62±1.38	11.17±1.21	1.898	0.060
VEGF(ng/mL)	212.32±63.21	188.68±54.79	2.191	0.030
ET-1(ng/L)	86.47±8.52	82.26±7.56	2.857	0.005
PT(s)	12.19±1.20	14.23±1.37	8.378	<0.001
APTT(s)	33.87±6.45	36.35±5.61	2.248	0.026
TT(s)	20.02±2.18	23.14±2.66	6.730	<0.001

模型阶段	因变量	自变量	β	SE	t	P值
总效应模型（PT）	术后复发	HbA1c	0.223	0.044	4.172	<0.001
中介变量模型（PT）	PT	HbA1c	0.157	0.059	3.283	<0.001
中介效应模型（PT）	术后复发	HbA1c	0.164	0.032	2.976	<0.001
中介效应模型（PT）	术后复发	PT	0.208	0.040	5.025	<0.001
总效应模型（APTT）	术后复发	HbA1c	0.130	0.036	3.193	<0.001
中介变量模型（APTT）	APTT	HbA1c	0.241	0.067	2.525	<0.001
中介效应模型（APTT）	术后复发	HbA1c	0.189	0.051	4.179	<0.001
中介效应模型（APTT）	术后复发	APTT	0.142	0.078	4.430	<0.001
总效应模型（TT）	术后复发	HbA1c	0.306	0.035	3.682	<0.001
中介变量模型（TT）	TT	HbA1c	0.211	0.043	5.634	<0.001
中介效应模型（TT）	术后复发	HbA1c	0.235	0.058	5.102	<0.001
中介效应模型（TT）	术后复发	TT	0.128	0.062	2.451	<0.001

模型阶段	因变量	自变量	β	SE	t	P值
总效应模型（PT）	术后复发	HbA1c	0.223	0.044	4.172	<0.001
中介变量模型（PT）	PT	HbA1c	0.157	0.059	3.283	<0.001
中介效应模型（PT）	术后复发	HbA1c	0.164	0.032	2.976	<0.001
中介效应模型（PT）	术后复发	PT	0.208	0.040	5.025	<0.001
总效应模型（APTT）	术后复发	HbA1c	0.130	0.036	3.193	<0.001
中介变量模型（APTT）	APTT	HbA1c	0.241	0.067	2.525	<0.001
中介效应模型（APTT）	术后复发	HbA1c	0.189	0.051	4.179	<0.001
中介效应模型（APTT）	术后复发	APTT	0.142	0.078	4.430	<0.001
总效应模型（TT）	术后复发	HbA1c	0.306	0.035	3.682	<0.001
中介变量模型（TT）	TT	HbA1c	0.211	0.043	5.634	<0.001
中介效应模型（TT）	术后复发	HbA1c	0.235	0.058	5.102	<0.001
中介效应模型（TT）	术后复发	TT	0.128	0.062	2.451	<0.001

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