Tuttolomondo Antonino, Casuccio Alessandra, Guercio Giovanni, Maida Carlo, Del Cuore Alessandro, Di Raimondo Domenico, Simonetta Irene, Di Bona Danilo, Pecoraro Rosaria, Della Corte Vittoriano, Gulotta Eliana, Gulotta Gaspare, Pinto Antonio
Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy.
U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche, n.2, 90127, Palermo, Italy.
Cardiovasc Diabetol. 2017 Jan 6;16(1):2. doi: 10.1186/s12933-016-0483-5.
Endothelial dysfunction is an early marker of cardiovascular disease so endothelial and arterial stiffness indexes are good indicators of vascular health. We aimed to assess whether the presence of diabetic foot is associated with arterial stiffness and endothelial function impairment.
We studied 50 subjects with type 2 diabetes mellitus and diabetic foot syndrome (DFS) compared to 50 diabetic subjects without diabetic foot, and 53 patients without diabetes mellitus, by means of the mini mental state examination (MMSE) administered to evaluate cognitive performance. Carotid-femoral pulse wave velocity (PWV) and augmentation index (Aix) were also evaluated by Applanation tonometry (SphygmoCor version 7.1), and the RH-PAT data were digitally analyzed online by Endo-PAT2000 using reactive hyperemia index (RHI) values.
In comparison to diabetic subjects without diabetic foot the subjects with diabetic foot had higher mean values of PWV, lower mean values of RHI, and lower mean MMSE. At multinomial logistic regression PWV and RHI were significantly associated with diabetic foot presence, whereas ROC curve analysis had good sensitivity and specificity in arterial PWV and RHI for diabetic foot presence.
Pulse wave velocity and augmentation index, mean RHI values, and mean MMSE were effective indicators of diabetic foot. Future research could address these issues by means of longitudinal studies to evaluate cardiovascular event incidence in relation to arterial stiffness, endothelial and cognitive markers.
内皮功能障碍是心血管疾病的早期标志物，因此内皮和动脉僵硬度指标是血管健康的良好指标。我们旨在评估糖尿病足的存在是否与动脉僵硬度和内皮功能损害相关。
我们研究了50例2型糖尿病合并糖尿病足综合征（DFS）的患者，与50例无糖尿病足的糖尿病患者以及53例非糖尿病患者进行比较，通过简易精神状态检查表（MMSE）评估认知能力。采用压平式眼压计（SphygmoCor 7.1版本）评估颈股脉搏波速度（PWV）和增强指数（Aix），并使用反应性充血指数（RHI）值通过Endo-PAT2000对RH-PAT数据进行在线数字分析。
与无糖尿病足的糖尿病患者相比，糖尿病足患者的PWV平均值更高，RHI平均值更低，MMSE平均值更低。在多项逻辑回归分析中，PWV和RHI与糖尿病足的存在显著相关，而ROC曲线分析在糖尿病足存在时对动脉PWV和RHI具有良好的敏感性和特异性。
脉搏波速度、增强指数、平均RHI值和平均MMSE是糖尿病足的有效指标。未来的研究可以通过纵向研究来解决这些问题，以评估与动脉僵硬度、内皮和认知标志物相关的心血管事件发生率。
