Li Jue, Luo Yingyi, Xu Yawei, Yang Jingang, Zheng Liqiang, Hasimu Buaijiaer, Yu Jinming, Hu Dayi
Heart, Lung and Blood Vessel Center, Tongji University, Shanghai, P.R.China.
Circ J. 2007 Mar;71(3):377-81. doi: 10.1253/circj.71.377.
The aim of the present study was to evaluate the risk factors for peripheral arterial disease and the relationship between the ankle - brachial index (ABI) and mortality from all-cause and cardiovascular disease (CVD) in Chinese patients with type 2 diabetes mellitus (DM).
ABI was identified at baseline by measuring systolic pressure in the bilateral brachial and tibial arteries. Mortality surveillance was completed from November 2004 to January 2006. Among 1,647 participants with type 2 DM at baseline, 531 (32.2%) were in the low-ABI group. Older age, female gender, higher serum level of total cholesterol, longer duration of DM and a history of smoking were associated with low ABI. During the 13-month follow-up, there were 132 deaths, of which 47 were from CVD. Low ABI was associated with mortality from all-cause and CVD, the adjusted relative risk of which was 1.851 (95% confidence interval 1.280-2.676) and 3.211 (1.703-6.053), respectively, in Cox regression models. The survival rate was significantly lower in the low-ABI group than in the normal-ABI group.
Low ABI was independently associated with a high risk of all-cause and CVD mortality in Chinese patients with type 2 DM. ABI should be promoted as an ideal tool for predicting mortality in diabetic patients.
本研究旨在评估中国2型糖尿病(DM)患者外周动脉疾病的危险因素以及踝臂指数(ABI)与全因死亡率和心血管疾病(CVD)死亡率之间的关系。
通过测量双侧肱动脉和胫动脉的收缩压在基线时确定ABI。死亡率监测于2004年11月至2006年1月完成。在基线时的1647名2型糖尿病参与者中,531名(32.2%)属于低ABI组。年龄较大、女性、血清总胆固醇水平较高、糖尿病病程较长和有吸烟史与低ABI相关。在13个月的随访期间,有132例死亡,其中47例死于心血管疾病。低ABI与全因死亡率和心血管疾病死亡率相关,在Cox回归模型中,其调整后的相对风险分别为1.851(95%置信区间1.280 - 2.676)和3.211(1.703 - 6.053)。低ABI组的生存率显著低于正常ABI组。
低ABI与中国2型糖尿病患者的全因和心血管疾病高死亡风险独立相关。ABI应被推广为预测糖尿病患者死亡率的理想工具。