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颈动脉和下肢超声检查联合应用可提高 2 型糖尿病患者动脉粥样硬化的检出率。

The combination of carotid and lower extremity ultrasonography increases the detection of atherosclerosis in type 2 diabetes patients.

机构信息

Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai key Laboratory of Diabetes Mellitus, Shanghai, China.

出版信息

J Diabetes Complications. 2012 Jan-Feb;26(1):23-8. doi: 10.1016/j.jdiacomp.2011.11.006. Epub 2012 Jan 5.

Abstract

OBJECTIVE

To evaluate the prevalence of atherosclerosis detected by both carotid and lower extremity ultrasonography in hospitalized Chinese type 2 diabetic patients and to examine whether plaque formation in the carotid arteries could be an indicator of generalized atherosclerosis in type 2 diabetes mellitus.

METHODS

Totally, 709 hospitalized Chinese type 2 diabetic patients (men 357, women 352) aged from 18 to 88 years were included. Both carotid and lower extremity atherosclerosis were assessed by Doppler ultrasound. Atherosclerosis was defined as the presence of either the carotid or lower extremity plaque in any of the above-mentioned arteries segments. The prevalence of atherosclerosis was calculated, and the risk factors associated with atherosclerosis were evaluated using binary logistic regression.

RESULTS

The prevalence of atherosclerosis was 81.23% in male and 77.56% in female type 2 diabetic patients, respectively. There was no significant difference in the prevalence of atherosclerosis in patients between the sexes. The prevalence of atherosclerosis was significantly higher in the lower extremity arteries than in the carotid arteries (73.91% and 44.43%, respectively, P<.001). Atherosclerosis was significantly associated with smoking, age, duration of diabetes, systolic blood pressure, total number of white blood cells, and mean carotid and femoral intima-media thickness (IMT).

CONCLUSIONS

The prevalence of atherosclerosis was very high in Chinese inpatients with type 2 diabetes. Carotid atherosclerosis could not be an indicator of generalized atherosclerosis in type 2 diabetes. The combination of carotid and lower extremity ultrasound examination can significantly improve the detection of atherosclerosis in type 2 diabetes.

摘要

目的

评估通过颈动脉和下肢超声检查发现的动脉粥样硬化在住院的中国 2 型糖尿病患者中的患病率,并探讨颈动脉斑块形成是否可以作为 2 型糖尿病全身性动脉粥样硬化的指标。

方法

共纳入 709 例年龄在 18 至 88 岁的住院中国 2 型糖尿病患者(男 357 例,女 352 例)。通过多普勒超声评估颈动脉和下肢动脉粥样硬化。将任何上述动脉节段存在颈动脉或下肢斑块定义为动脉粥样硬化。计算动脉粥样硬化的患病率,并使用二元逻辑回归评估与动脉粥样硬化相关的危险因素。

结果

男性 2 型糖尿病患者的动脉粥样硬化患病率为 81.23%,女性为 77.56%。性别间动脉粥样硬化的患病率无显著差异。下肢动脉粥样硬化的患病率显著高于颈动脉(分别为 73.91%和 44.43%,P<.001)。动脉粥样硬化与吸烟、年龄、糖尿病病程、收缩压、白细胞总数以及颈动脉和股动脉内膜中层厚度(IMT)均值显著相关。

结论

中国住院 2 型糖尿病患者的动脉粥样硬化患病率非常高。颈动脉粥样硬化不能作为 2 型糖尿病全身性动脉粥样硬化的指标。颈动脉和下肢超声联合检查可显著提高 2 型糖尿病患者动脉粥样硬化的检出率。

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