What are the factors affecting diabetic macrovascular disease? —The statistics of the World Health Organization in 2011 show that the number of people with diabetes has reached 347 million worldwide, which has become the third largest non-communicable disease in the world after cardiovascular disease and tumor. 2013, the number of adults with diabetes in China has reached 92.4 million, and the incidence of diabetes in China has increased from The prevalence of diabetes in China rose from 1% in 1980 to 9.7% in 2010 and is increasing year by year. Compared with type 1 diabetes, type 2 diabetes has a relatively slow onset and longer duration. type 2 diabetes has a high prevalence of macroangiopathy, which occurs early and has many associated risk factors, and is one of the most important causes of death and disability in diabetic patients, especially when complicated by various cardiovascular diseases. The mortality rate is 2 to 8 times higher than that of non-diabetic patients, and 75% to 80% of diabetic patients die from macroangiopathy. Diabetic macrovascular disease mainly refers to the occurrence of atherosclerosis in medium or large arteries, mainly involving the aorta, coronary arteries, cerebral arteries, renal arteries and peripheral vessels and other large vessels, and the common clinical diseases are coronary heart disease, stroke and carotid and lower limb atherosclerosis and gangrene, etc. The pathogenesis of macrovascular complications of type 2 diabetes is very complex, and the traditional view is that it is related to genetic susceptibility, insulin resistance, long-term The pathogenesis of macrovascular complications in type 2 diabetes is complex. The risk factors for macrovascular complications of type 2 diabetes can be divided into two categories, one is directly related to glucose metabolism, such as insulin resistance, hyperinsulinemia, insufficient insulin secretion, hyperglycemia, blood glucose fluctuations, etc. The other category is the traditional risk factors for the occurrence of cardiovascular diseases, such as age, gender, race, smoking history, genetic factors, poor lifestyle The other category is traditional risk factors for the occurrence of cardiovascular diseases, such as age, gender, race, smoking history, genetic factors, poor lifestyle, hypertension, dyslipidemia, obesity, abnormal blood rheology, etc. Insulin resistance is one of the key reasons for the development of diabetes, and diabetes is often accompanied by hyperinsulinemia in the early stages. Insulin resistance and hyperinsulinemia are closely related to diabetic macroangiopathy. Diabetic macroangiopathy first damages the structure of vascular smooth muscle cells and the integrity of vascular endothelial cells. Insulin resistance compensatory hyperinsulinemia can stimulate vascular endothelial cells to synthesize and release more endothelin and reduce nitric oxide thus occurring powerful vasoconstrictive effect, leading to disturbance of normal vascular diastolic function mediated by vascular endothelial cells. Hypertension is one of the important risk factors for the development of cardiovascular and cerebrovascular complications in diabetes. Hypertension accounts for 40% to 60% of type 2 diabetic patients, and there are many reasons for the increased incidence of hypertension in diabetic patients, hypertension is the most important controllable risk factor for chronic complications of diabetes. The incidence of cardiovascular disease and death rates in diabetic patients with combined hypertension were two times higher than those without combined hypertension, and four times higher than those of non-diabetic normotensive patients. This is a strong indication that strict blood pressure control can significantly reduce the risk of macrovascular disease in diabetic patients. Chronic hyperglycemia, especially postprandial hyperglycemia, is strongly associated with macrovascular complications and has an independent correlation with cardiovascular events and their accompanying morbidity and mortality, even in diabetic patients with reduced glucose tolerance, whose incidence of macrovascular disease is significantly increased. Dyslipidemia is also an important risk factor for macrovascular complications in diabetic patients. dyslipidemia in type 2 diabetes is mainly manifested by elevated triglycerides, very low density lipoprotein, low density lipoprotein-cholesterol, reduced high density lipoprotein-cholesterol and postprandial hyperlipidemia. An increase in LDL-C of 0.26 mmol/L increases the risk of coronary atherosclerotic heart disease by 12%, and a decrease in HDL-cholesterol of 0.26 mmol/L increases this risk by 22%. The incidence of coronary atherosclerotic heart disease is seven times higher in people with plasma cholesterol levels above 6.89 mmol/L than in those below 5.2 mmol/L; and a 25% reduction in plasma cholesterol levels can reduce the incidence of atherosclerosis by 50%. In recent years, it has also been shown that elevated postprandial triacylglycerol levels can lead to deterioration of endothelial function and that postprandial triacylglycerol levels have become an independent risk factor for early carotid atherosclerosis [15]. Age, gender, race, smoking history, genetic factors, obesity, and poor lifestyle are also risk factors for atherosclerosis; age is an independent risk factor for atherosclerosis. Epidemiological surveys show that the prevalence of atherosclerosis tends to increase with age. While women have less prevalence than men, postmenopausal prevalence is similar to that of men in the same age group. Smoking is also an independent risk factor for diabetic vasculopathy, and the mechanism of smoking-induced atherosclerosis is currently thought to be related to toxic substances such as carbon monoxide, nicotine, and cadmium, which can contribute to the development of atherosclerosis through their effects on lipoproteins and blood rheology. The increased concentration of carbon monoxide in the blood of smokers can cause hypoxic damage to the vascular endothelium. Obesity also affects the macrovascular complications of diabetes, and obesity itself is an important risk factor, associated with the secretion of several adipocytokines. Genetic factors are also a risk factor for vascular complications in T2DM, and type 2 diabetes runs in families.