Hsieh Ming-Chia, Tien Kai-Jen, Perng Daw-Shyong, Hsiao Jeng-Yueh, Chang Shun-Jen, Liang Hui-Ting, Chen Hung-Chun, Tu Shih-Te
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, 807 Taiwan.
Metabolism. 2009 Apr;58(4):504-9. doi: 10.1016/j.metabol.2008.11.008.
The risk for peripheral arterial disease (PAD) is increased in patients with chronic kidney disease. We investigated the effects of renal function on PAD in Chinese with type 2 diabetes mellitus. This study enrolled a total of 2983 (1342 men and 1641 women) Chinese adults with diabetes. The mean age was 63.2 +/- 11.9 years. Peripheral arterial disease was diagnosed by an ankle-brachial index less than 0.9. Renal function was evaluated by serum creatinine (SCr), estimated glomerular filtration rate, and urinary albumin-creatinine ratio (ACR). Risk factors for PAD were evaluated using multiple logistic regression analysis. Age, cholesterol, and high-density lipoprotein cholesterol (HDL-C) (inverse association) were significant risk factors in men, whereas age, body mass index (inverse association), low-density lipoprotein cholesterol, and HDL-C (inverse association) were significant risk factors for diabetic women. After adjustment for age, body mass index, blood pressure, glycosylated hemoglobin, cholesterol, HDL-C, low-density lipoprotein cholesterol, and triglyceride levels, we found that SCr levels greater than 1.5 mg/dL, estimated glomerular filtration rate less than 60 mL/min, and urinary ACR greater than 30 mg/g were independent risk factors for PAD in diabetic men and that SCr levels greater than 1.4 mg/dL and urinary ACR greater than 30 mg/g were independently associated with PAD in diabetic women. The risk factors for PAD are somewhat different between men and women with diabetes in Chinese population in Taiwan. Diabetic nephropathy is significantly associated with PAD in this patient population.
慢性肾病患者外周动脉疾病（PAD）的风险增加。我们调查了肾功能对中国2型糖尿病患者PAD的影响。本研究共纳入2983名（1342名男性和1641名女性）中国成年糖尿病患者。平均年龄为63.2±11.9岁。外周动脉疾病通过踝臂指数小于0.9诊断。肾功能通过血清肌酐（SCr）、估算肾小球滤过率和尿白蛋白肌酐比值（ACR）进行评估。使用多因素逻辑回归分析评估PAD的危险因素。年龄、胆固醇和高密度脂蛋白胆固醇（HDL-C）（负相关）是男性的重要危险因素，而年龄、体重指数（负相关）、低密度脂蛋白胆固醇和HDL-C（负相关）是糖尿病女性的重要危险因素。在调整年龄、体重指数、血压、糖化血红蛋白、胆固醇、HDL-C、低密度脂蛋白胆固醇和甘油三酯水平后，我们发现男性糖尿病患者中，SCr水平大于1.5mg/dL、估算肾小球滤过率小于60mL/min和尿ACR大于30mg/g是PAD的独立危险因素，而女性糖尿病患者中，SCr水平大于1.4mg/dL和尿ACR大于30mg/g与PAD独立相关。在台湾中国人群中，糖尿病男性和女性PAD的危险因素有所不同。在该患者群体中，糖尿病肾病与PAD显著相关。
