颈动脉内膜中层厚度和斑块与糖尿病患者外周动脉疾病的指标有关。
Carotid intima-media thickness and plagues are associated with indicators of peripheral artery diseases in patients with diabetes.
机构信息
Central Hospital of Shanghai Jiading District, Shanghai 201800, China.
State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China; Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
出版信息
Diabetes Res Clin Pract. 2018 Oct;144:245-251. doi: 10.1016/j.diabres.2018.08.017. Epub 2018 Sep 5.
AIMS
We investigated associations of carotid intima-media thickness (CIMT) and carotid plaque with ankle-brachial index (ABI) and toe-brachial index (TBI) in Chinese adults.
METHODS
A cross-sectional analysis was performed in 6688 participants from a well-defined Chinese community. CIMT and carotid plaque was measured with a high-resolution B-mode tomographic ultrasound system. Low ABI was defined as ABI ≤ 0.90. Low TBI was defined as TBI ≤ 0.60. Carotid plaques were classified as normal, homogeneous or heterogeneous according to morphology.
RESULTS
After adjusting for age, sex and body mass index, each 0.10 mm CIMT increase was associated with 0.0123 unit decrease in TBI (P = 0.004) and 0.0063 in ABI (P = 0.04) in patients with diabetes. After further adjustments for waist circumference, smoking and drinking habits, hypertension, lipids and hemoglobin A1c, the associations between CIMT and TBI remained significant; while those with ABI were disappeared. Meanwhile, each 0.10 mm increment of CIMT or rank of carotid plaque morphology was associated with a risk of presence of low TBI (CIMT: odds ratio: 1.21, 95% confidence interval: 1.05-1.40; carotid plaque morphology: 1.45, 1.01-2.08) in patients with diabetes after adjustments. However, no associations were found between CIMT or carotid plaque morphology and TBI or ABI in non-diabetic participants.
CONCLUSIONS
CIMT and carotid plaque morphology were significantly associated with TBI in patients with diabetes.
目的
我们研究了中国成年人颈动脉内膜中层厚度（CIMT）和颈动脉斑块与踝臂指数（ABI）和趾臂指数（TBI）的关系。
方法
对来自一个明确界定的中国社区的 6688 名参与者进行了横断面分析。使用高分辨率 B 型断层超声系统测量 CIMT 和颈动脉斑块。低 ABI 定义为 ABI≤0.90。低 TBI 定义为 TBI≤0.60。根据形态将颈动脉斑块分为正常、均质或异质。
结果
在调整年龄、性别和体重指数后，糖尿病患者中每增加 0.10 毫米 CIMT 与 TBI 降低 0.0123 单位（P=0.004）和 ABI 降低 0.0063（P=0.04）相关。在进一步调整腰围、吸烟和饮酒习惯、高血压、血脂和糖化血红蛋白后，CIMT 与 TBI 之间的关联仍然显著；而与 ABI 的关联则消失。同时，CIMT 或颈动脉斑块形态每增加 0.10 毫米或等级与糖尿病患者存在低 TBI 的风险相关（CIMT：比值比：1.21，95%置信区间：1.05-1.40；颈动脉斑块形态：1.45，1.01-2.08），经调整后。然而，在非糖尿病参与者中，CIMT 或颈动脉斑块形态与 TBI 或 ABI 之间没有关联。
结论
CIMT 和颈动脉斑块形态与糖尿病患者的 TBI 显著相关。
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