Department of Internal Medicine of Endocrinology and Metabolism, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano, Osaka 586-8521, Japan.
Diabetol Metab Syndr. 2014 Apr 8;6(1):51. doi: 10.1186/1758-5996-6-51.
The vascular complications of outpatients with diabetes at ordinary hospitals vary. Ischemic heart disease is barely predictable after treatment using previously reported therapeutic indices. We developed a simple and noninvasive screening method to evaluate the possibility of ischemic heart disease in patients with diabetes.
Five years of clinical data from 337 outpatients (196 males and 141 females) with diabetes were analyzed. Twenty-three males and 14 females had ischemic heart disease. We examined the possibility of predicting ischemic heart disease after analyzing this population. The analyzed laboratory data included the following: minimum value of right or left ankle-brachial indices (ABI), maximum value of right or left pulse wave velocities (PWV), aortic calcification diagnosed on plain chest radiographs, plaque score (PS), maximum value of intima media thickness at the cervical artery (IMT), electrocardiographic (ECG) ischemic changes (including ST-T changes or abnormal Q waves, which were re-examined by a cardiologist), HbA1c, low-density lipoprotein cholesterol (LDL-C), uric acid (UA), urine albumin, age, sex, disease duration, and body mass index. All data were subjected to multivariate logistic regression analyses.
The presence of ECG ischemic changes, aortic calcification, minimum ABI, maximum IMT, LDL-C, and UA were evaluated in multivariate logistic regression analysis with the onset of ischemic heart disease. The receiver operating characteristic curve indicated an area under the curve of 0.879 (0.820 - 0.938; P = 0.00).
Ischemic heart disease could be predicted in patients with diabetes using a combination of results from conventional physical and laboratory tests.
普通医院的门诊糖尿病患者的血管并发症各不相同。使用以前报道的治疗指数治疗后，几乎无法预测缺血性心脏病。我们开发了一种简单且无创的筛选方法来评估糖尿病患者发生缺血性心脏病的可能性。
分析了 337 例门诊（196 例男性和 141 例女性）糖尿病患者 5 年的临床数据。23 例男性和 14 例女性患有缺血性心脏病。我们通过分析该人群来检查预测缺血性心脏病的可能性。分析的实验室数据包括以下内容：右或左踝臂指数（ABI）的最小值、右或左脉搏波速度（PWV）的最大值、胸部平片诊断的主动脉钙化、斑块评分（PS）、颈总动脉内膜中层厚度（IMT）的最大值、心电图（ECG）缺血变化（包括 ST-T 改变或异常 Q 波，由心脏病专家重新检查）、HbA1c、低密度脂蛋白胆固醇（LDL-C）、尿酸（UA）、尿白蛋白、年龄、性别、疾病持续时间和体重指数。所有数据均进行多变量逻辑回归分析。
在多变量逻辑回归分析中，用心电图缺血改变、主动脉钙化、最小 ABI、最大 IMT、LDL-C 和 UA 评估缺血性心脏病的发生。受试者工作特征曲线表明曲线下面积为 0.879（0.820-0.938；P=0.00）。
可以使用常规体格检查和实验室检查结果的组合来预测糖尿病患者的缺血性心脏病。
