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诗琳通公主殿下医疗中心2型糖尿病患者外周动脉疾病的患病率及危险因素

Prevalence and risk factors of peripheral arterial disease in type 2 diabetic patients at HRH Princess Maha Chakri Sirindhorn Medical Center.

作者信息

Chuengsamarn Somlak, Sangpanich Aroonchai, Laoopugsin Niyom

机构信息

Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2010 Feb;93 Suppl 2:S32-8.

Abstract

OBJECTIVE

To study the prevalence and risk factors of PAD in type 2 diabetes.

MATERIAL AND METHOD

The crossectional study randomly enrolled 219 diabetic patients to study in Year 2006-2007. All subjects were checked up and recorded basic information and affecting factors to risk of PAD. ABI scores were measured by Colin VP-1000 machine. The affecting factors to PAD risk were analyzed to obtain form descriptive (percent and number) and inferential statistics (odds ratio).

RESULTS

There were 219 diabetic patients included in this study with 61.2% of females and 38.8% of males. The prevalence of PAD and intermittent claudication symptoms were 60.3% and 60.7%, respectively. The patients who had current smoking, hypertriglyceridemia, low HDL and HbA1c > or = 7.0% have statistically significant increased risk of PAD odds ratio of 31.89 (95% CI = 4.31-236.0), 5.20 (95% CI = 1.67-16.18), 7.05 (95% CI = 2.29-21.72) and 2.74 (95% CI = 1.07-7.06), respectively, while the groups who had older age (> or = 60 years), duration of DM of > or = 10 years and waist circumference of > or = 90 cm. in men or > or = 80 cm. in women have not statistically significant increased risk of odds ratios of 1.84 (95% CI = 0.77-4.43), 1.11 (95% CI = 0.41-3.04) and 1.69 (95% CI = 0.51-5.6). The patients who had combinations of microvascular complication, previous history of CHD and stroke had significantly statistic risk of odds ratio 8.97 (95% CI = 2.82-28.60) and 5.63 (95% CI = 1.91-16.57) although we needed to measure ABI score in all type 2 diabetes with high risks and CVD.

CONCLUSION

The diabetic patients with high risk and CVD have high prevalence of PAD. Patients with suspected PAD may needs further examination and patients who have increased risk of PAD may require interventions to prevent vascular complications.

摘要

目的

研究2型糖尿病患者外周动脉疾病(PAD)的患病率及危险因素。

材料与方法

这项横断面研究于2006 - 2007年随机纳入219例糖尿病患者进行研究。对所有受试者进行检查并记录基本信息以及PAD风险的影响因素。采用科林VP - 1000仪器测量踝臂指数(ABI)得分。对PAD风险的影响因素进行分析,以获得描述性(百分比和数量)和推断性统计(比值比)结果。

结果

本研究纳入219例糖尿病患者,其中女性占61.2%,男性占38.8%。PAD患病率和间歇性跛行症状发生率分别为60.3%和60.7%。当前吸烟、高甘油三酯血症、高密度脂蛋白水平低以及糖化血红蛋白(HbA1c)≥7.0%的患者发生PAD的风险在统计学上显著增加,比值比分别为31.89(95%置信区间 = 4.31 - 236.0)、5.20(95%置信区间 = 1.67 - 16.18)、7.05(95%置信区间 = 2.29 - 21.72)和2.74(95%置信区间 = 1.07 - 7.06),而年龄≥60岁、糖尿病病程≥10年以及男性腰围≥90 cm或女性腰围≥80 cm的患者发生PAD的风险增加在统计学上无显著差异,比值比分别为1.84(95%置信区间 = 0.77 - 4.43)、1.11(95%置信区间 = 0.41 - 3.04)和1.69(95%置信区间 = 0.51 - 5.6)。合并微血管并发症、有冠心病和中风病史的患者发生PAD的风险在统计学上有显著增加,比值比分别为8.97(95%置信区间 = 2.82 - 28.60)和5.63(95%置信区间 = 1.91 - 16.57),不过我们需要对所有高危2型糖尿病和心血管疾病(CVD)患者测量ABI得分。

结论

高危和CVD的糖尿病患者PAD患病率较高。疑似PAD的患者可能需要进一步检查,而发生PAD风险增加的患者可能需要采取干预措施以预防血管并发症。

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