Tsunoda Keiko, Shimajiri Yoshinori, Morita Shuhei, Furuta Machi, Kadoya Yoshiki, Yamada Shoichi, Nanjo Kishio, Sanke Tokio
Department of Clinical Laboratory Medicine, Wakayama Medical University, Wakayama 641-8509, Japan.
Metab Syndr Relat Disord. 2009 Aug;7(4):323-6. doi: 10.1089/met.2008.0074.
Chronic kidney disease (CKD) and metabolic syndrome have been recognized as risk factors for cardiovascular disease. However, there is no information comparing their impact on macroangiopathy in diabetic patients. Thus, we studied the prevalence of CKD and metabolic syndrome in Japanese type 2 diabetic patients and then compared their impact on peripheral arterial disease (PAD) in type 2 diabetic patients.
This study focused on Japanese type 2 diabetic patients without hemodialysis (n = 1014). Patients with albuminuria, including microalbuminuria and/or an estimated glomerular filtration rate less than 60 mL/min/1.73(2), were diagnosed as having CKD. PAD was defined as ankle-brachial blood pressure index less than 0.9.
The prevalence of CKD and metabolic syndrome was 47.1% and 39.6%, respectively. In four age- and duration-matched groups classified by the presence or absence of CKD and metabolic syndrome, the prevalence of PAD was significantly higher in groups with CKD alone than those with metabolic syndrome alone, and the high prevalence in the groups with CKD was not influenced by the coexistence with metabolic syndrome.
This study indicates that CKD has more powerful impact on PAD than metabolic syndrome in type 2 diabetic patients.
慢性肾脏病（CKD）和代谢综合征已被公认为心血管疾病的危险因素。然而，尚无关于它们对糖尿病患者大血管病变影响的比较信息。因此，我们研究了日本2型糖尿病患者中CKD和代谢综合征的患病率，然后比较了它们对2型糖尿病患者外周动脉疾病（PAD）的影响。
本研究聚焦于未接受血液透析的日本2型糖尿病患者（n = 1014）。白蛋白尿患者，包括微量白蛋白尿和/或估计肾小球滤过率低于60 mL/min/1.73(2)，被诊断为患有CKD。PAD定义为踝臂血压指数低于0.9。
CKD和代谢综合征的患病率分别为47.1%和39.6%。在根据是否存在CKD和代谢综合征分类的四个年龄和病程匹配组中，单纯CKD组的PAD患病率显著高于单纯代谢综合征组，且CKD组的高患病率不受与代谢综合征共存的影响。
本研究表明，在2型糖尿病患者中，CKD对PAD的影响比代谢综合征更强。
