Hiatt W R, Marshall J A, Baxter J, Sandoval R, Hildebrandt W, Kahn L R, Hamman R F
Department of Medicine, University of Colorado School of Medicine, Denver 80262.
J Clin Epidemiol. 1990;43(6):597-606. doi: 10.1016/0895-4356(90)90164-k.
Peripheral arterial disease (PAD) is a frequent complication of diabetes mellitus. In the first phase of the San Luis Valley Diabetes Study, diagnostic criteria for PAD were evaluated in 607 controls and 343 diabetics. Normal ranges, and the lowest 2.5 percentile of the distribution of ankle/arm systolic blood pressure ratios were derived from a non-diabetic subset of the population with a very low probability of PAD. From this subgroup, abnormal ankle/arm ratios were defined as less than: 0.94 at rest, 0.73 after exercise, and 0.78 after reactive hyperemia. Using these criteria, PAD was identified in 130 subjects from the study population of 950 (prevalence of 13.7%). In contrast, a history of intermittent claudication, or an absent pulse in the extremity were uncommon findings in the study population, and thus had a low sensitivity and positive predictive value for PAD diagnosed by vascular laboratory criteria. We conclude that vascular laboratory tests provide a useful, and objective means of determining the prevalence of PAD in a geographically-based population of diabetic and control subjects.
外周动脉疾病（PAD）是糖尿病常见的并发症。在圣路易斯谷糖尿病研究的第一阶段，对607名对照者和343名糖尿病患者进行了PAD诊断标准的评估。正常范围以及踝/臂收缩压比值分布的最低2.5百分位数是从患PAD可能性极低的非糖尿病人群子集中得出的。在这个亚组中，异常的踝/臂比值定义为：静息时小于0.94，运动后小于0.73，反应性充血后小于0.78。根据这些标准，在950名研究对象中有130人被诊断为PAD（患病率为13.7%）。相比之下，间歇性跛行病史或肢体脉搏消失在研究人群中并不常见，因此对于通过血管实验室标准诊断的PAD，其敏感性和阳性预测值较低。我们得出结论，血管实验室检测为确定基于地理位置的糖尿病和对照人群中PAD的患病率提供了一种有用且客观的方法。
