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在中国患有心脏代谢危险因素的患者中,糖尿病与下肢早期慢性静脉疾病相关。

Diabetes mellitus is associated with early chronic venous disorder of the lower extremities in Chinese patients with cardiometabolic risk factors.

作者信息

Zhong Jian, Chen Jing, Zhao Zhi-gang, He Hong-bo, Yan Zhen-cheng, Liu Dao-yan, Zhu Zhi-ming, Ni Yin-xing

机构信息

Centre for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China.

出版信息

Diabetes Metab Res Rev. 2014 Sep;30(6):505-12. doi: 10.1002/dmrr.2551.

Abstract

BACKGROUND

Metabolic syndrome has received great attention because it poses a potential cardiovascular hazard, which increases the risk of lower extremity atherosclerosis. However, the relationship between the components of metabolic syndrome and the onset of chronic venous disorder of the lower extremities remains unexplained.

METHODS

This study investigated the characteristics of cardiometabolic risk factors of early chronic venous disorder of the lower extremities in subjects with cardiometabolic risk. The characteristics of risk factors and diabetes-related complications in diabetic patients with early chronic venous disorder of the lower extremities were also investigated. In addition, the association between early chronic venous disorder and atherosclerosis of the lower extremities was analysed. The study examined 782 subjects with cardiometabolic risk factors, including obesity, hypertension, diabetes mellitus and dyslipidaemia. Lower extremity venous function was measured by digital photoplethysmography.

RESULTS

Women had a higher prevalence of early chronic venous disorder than did men (p < 0.01). Male subjects with early chronic venous disorder had a higher systolic blood pressure than those with normal venous function (p < 0.01), and female subjects with early chronic venous disorder had a higher fasting plasma glucose level than did controls (p < 0.05). The prevalence of diabetes mellitus is also significantly higher in female patients with early chronic venous disorder (p = 0.000). Diabetic patients with early chronic venous disorder not only had higher fasting plasma glucose and total cholesterol levels but also had more serious macrovascular complications than the control group. The independent risk factors of early chronic venous disorder in female subjects with cardiometabolic risks were age and fasting plasma glucose in men it was only age Women face a two times greater risk than men. The independent risk factors of early chronic venous disorder in diabetic patients were age, gender, HbA1c and triglyceride levels Women had an almost 12 times greater risk of early chronic venous disorder than men. Among the diabetic patients, the prevalence of early chronic venous disorder did not differ by ankle-brachial index.

CONCLUSION

Female subjects with cardiometabolic risk factors or female diabetic patients face a greater risk of early chronic venous disorder than do male subjects. Diabetic patients with early chronic venous disorder had more serious macrovascular complications than did the controls, and the early venous function was found to be correlated with the blood glucose level and triglyceride status.

摘要

背景

代谢综合征因其构成潜在的心血管危害而备受关注,这种危害会增加下肢动脉粥样硬化的风险。然而,代谢综合征各组分与下肢慢性静脉疾病发病之间的关系仍未明确。

方法

本研究调查了存在心脏代谢风险的受试者下肢早期慢性静脉疾病的心脏代谢危险因素特征。还研究了患有下肢早期慢性静脉疾病的糖尿病患者的危险因素及糖尿病相关并发症特征。此外,分析了下肢早期慢性静脉疾病与下肢动脉粥样硬化之间的关联。该研究纳入了782名存在心脏代谢危险因素的受试者,包括肥胖、高血压、糖尿病和血脂异常。通过数字光电容积描记法测量下肢静脉功能。

结果

女性早期慢性静脉疾病的患病率高于男性(p < 0.01)。患有早期慢性静脉疾病的男性受试者收缩压高于静脉功能正常者(p < 0.01),患有早期慢性静脉疾病的女性受试者空腹血糖水平高于对照组(p < 0.05)。患有早期慢性静脉疾病的女性患者中糖尿病患病率也显著更高(p = 0.000)。患有早期慢性静脉疾病的糖尿病患者不仅空腹血糖和总胆固醇水平更高,而且大血管并发症比对照组更严重。存在心脏代谢风险的女性受试者早期慢性静脉疾病的独立危险因素是年龄和空腹血糖,男性则只有年龄,女性面临的风险是男性的两倍。糖尿病患者早期慢性静脉疾病的独立危险因素是年龄、性别、糖化血红蛋白和甘油三酯水平,女性发生早期慢性静脉疾病的风险几乎是男性的12倍。在糖尿病患者中,早期慢性静脉疾病的患病率在踝臂指数方面无差异。

结论

存在心脏代谢危险因素的女性受试者或女性糖尿病患者比男性受试者面临更高的早期慢性静脉疾病风险。患有早期慢性静脉疾病的糖尿病患者比对照组有更严重的大血管并发症,且早期静脉功能与血糖水平和甘油三酯状况相关。

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