Yeh Chi-Hsiao, Yu Hsiu-Chin, Huang Tzu-Yen, Huang Pin-Fu, Wang Yao-Chang, Chen Tzu-Ping, Yin Shun-Ying
Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
Department of Nursing, Chang Gung Memorial Hospital, Keelung, Taiwan.
Biomed Res Int. 2016;2016:9872945. doi: 10.1155/2016/9872945. Epub 2016 Oct 18.
. To assess whether the visit-to-visit variability in blood pressure (BP) is a risk factor of peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (T2DM) 10 years after diagnosis. . The electronic medical records of 825 patients, who were diagnosed with type 2 diabetes mellitus (T2DM) during 2000-2002 and regularly followed for 10 years, were retrospectively reviewed. A total of 53,284 clinic visit records, including analysis of BP, BMI, serum glycohemoglobin, and lipid profile, were analyzed. . Patients were categorized into two groups according to their visit-to-visit variability in systolic and diastolic BP (SBP and DBP, resp.). The high-risk group included patients with high SBP and DBP visit-to-visit variability; this group had a 1.679-fold (95% CI: 1.141-2.472, = 0.009) increased risk of PAD compared with patients in the low-risk group. Cox regression analysis also demonstrated that the age at which the patients were diagnosed with T2DM, smoking status, and mean creatinine level was significantly associated with increased risk of PAD with a hazard ration of 1.064 (95% CI: 1.043-1.084, < 0.001), 1.803 (95% CI: 1.160-2.804, = 0.009), and 1.208 (95% CI: 1.042-1.401, = 0.012), respectively. . High SBP and DBP visit-to-visit variability is correlated with PAD in the first decade following a diagnosis of T2DM.
评估确诊2型糖尿病（T2DM）10年后，血压（BP）逐次就诊间变异性是否为外周动脉疾病（PAD）的危险因素。对2000年至2002年期间确诊为2型糖尿病（T2DM）并定期随访10年的825例患者的电子病历进行回顾性分析。共分析了53284份临床就诊记录，包括血压、体重指数、糖化血红蛋白和血脂谱分析。根据收缩压和舒张压（分别为SBP和DBP）的逐次就诊间变异性将患者分为两组。高危组包括收缩压和舒张压逐次就诊间变异性高的患者；与低危组患者相比，该组患PAD的风险增加了1.679倍（95%CI：1.141-2.472，P=0.009）。Cox回归分析还表明，患者确诊T2DM的年龄、吸烟状况和平均肌酐水平与患PAD风险增加显著相关，风险比分别为1.064（95%CI：1.043-1.084，P<0.001）、1.803（95%CI：1.160-2.804，P=0.009）和1.208（95%CI：1.042-1.401，P=0.012）。收缩压和舒张压逐次就诊间变异性高与T2DM诊断后的第一个十年内的PAD相关。
