Elsharawy M A, Al-Elq A H, Alkhadra A H, Moghazy K M, Elsaid A S
Department of Surgery, King Faisal University, Al-Khobar, Kingdom of Saudi Arabia.
Int Angiol. 2011 Feb;30(1):52-7.
Diabetes mellitus is a major risk factor for atherosclerosis and accordingly increased morbidity and mortality. This study aimed at screening high risk diabetic patients for atherosclerosis in different arterial territories.
All high risk asymptomatic patients attending the diabetic clinic, King Fahd Hospital of the University, Saudi Arabia were invited to be screened for peripheral arterial disease (PAD), extra-cranial cerebrovascular disease (CVD) and coronary artery disease (CAD) over one year. All participants underwent measurement of ankle brachial pressure index, carotid Duplex scan and exercise electrocardiography (ECG). All patients underwent evaluation of conventional risk factors for atherosclerosis
One hundred and sixty nine patients were invited to be screened. Of these 138 (82%) completed all the screening tests. The mean age was 53.5±7.18 years. Seventy-five (55%) had evidence of subclinical atherosclerosis. In the atherosclerotic group, 24 patients had PAD, 47 had CVD and 30 had CAD. There were significant differences between the atherosclerotic and non-atherosclerotic groups with regard to most risk factors. In age, sex adjusted, the risk of developing atherosclerosis was significantly increased with all risk factors. Dyslipidemia had the highest association (OR 9.7, 95% CI 8.1-10.2)
Participation and diagnostic yield of screening for atherosclerosis had satisfactory validity and reliability. Routine screening in high-risk diabetic patients can serve as an effective tool for diagnosis of sub clinical cardiovascular disease and provide strategies to optimize risk reduction.
糖尿病是动脉粥样硬化的主要危险因素，因此会增加发病率和死亡率。本研究旨在筛查不同动脉区域存在动脉粥样硬化的高危糖尿病患者。
邀请沙特阿拉伯法赫德国王大学医院糖尿病门诊的所有高危无症状患者在一年时间内接受外周动脉疾病（PAD）、颅外脑血管疾病（CVD）和冠状动脉疾病（CAD）的筛查。所有参与者均接受踝臂压力指数测量、颈动脉双功超声扫描和运动心电图（ECG）检查。所有患者均接受动脉粥样硬化传统危险因素的评估。
169名患者被邀请参加筛查。其中138名（82%）完成了所有筛查测试。平均年龄为53.5±7.18岁。75名（55%）有亚临床动脉粥样硬化的证据。在动脉粥样硬化组中，24名患者患有PAD，47名患有CVD，30名患有CAD。在大多数危险因素方面，动脉粥样硬化组和非动脉粥样硬化组之间存在显著差异。在年龄、性别调整后，所有危险因素都会使发生动脉粥样硬化的风险显著增加。血脂异常的关联性最高（比值比9.7，95%可信区间8.1 - 10.2）。
动脉粥样硬化筛查的参与率和诊断率具有令人满意的有效性和可靠性。对高危糖尿病患者进行常规筛查可作为诊断亚临床心血管疾病的有效工具，并提供优化风险降低的策略。
