Department of Endocrinology, Peking University International Hospital, Beijing, 100001, China.
Department of Endocrinology, West China Hospital, Sichuan University, Sichuan, 610041, China.
Sci Rep. 2020 Feb 21;10(1):3182. doi: 10.1038/s41598-019-55101-1.
This study aimed to analyze the clinical characteristics of lower extremity atherosclerotic disease (LEAD) in Chinese adult type 2 diabetes (T2D) patients, and also explored the risk factors for LEAD and developed simple-to-use nomograms for LEAD and lesion degree in these patients. We retrospectively studied 4422 patients (male = 2084; female = 2338) with T2D who were ≥50. Based on lower extremity arterial ultrasound findings, we divided the patients into three groups: normal, mild, and moderate-to-severe group. The factors related to LEAD in patients with T2D were analyzed by logistic regression analysis. The risk factors for moderate-to-severe LEAD included: high HbA1c (OR = 1.07 95% CI 1.02-1.13), diabetic peripheral neuropathy (OR = 1.93 95% CI 1.57-2.37), and diabetic retinopathy (OR = 1.26 95%CI 1.01-1.57). The overall areas under the receiver operating characteristic curves for the nomograms for predicting the risks of LEAD and moderate-to-severe LEAD in adult T2D patients were 0.793 (95%CI 0.720, 0.824) and 0.736 (95%CI 0.678, 0.795), respectively. The developed nomograms are simple to use and enable preliminary visual prediction of the risk and degree of LEAD in Chinese T2D patients over 50 years. The nomograms are accurate to a certain degree and provide a clinical basis for predicting the occurrence and progression of LEAD.
本研究旨在分析中国成年 2 型糖尿病(T2D)患者下肢动脉粥样硬化性疾病(LEAD)的临床特征,并探讨 LEAD 的危险因素,为这些患者开发简单易用的 LEAD 和病变程度列线图。我们回顾性研究了 4422 名年龄≥50 岁的 T2D 患者(男性 2084 名,女性 2338 名)。根据下肢动脉超声结果,将患者分为三组:正常、轻度和中重度组。采用 logistic 回归分析 T2D 患者 LEAD 的相关因素。中重度 LEAD 的危险因素包括:高 HbA1c(OR=1.07,95%CI 1.02-1.13)、糖尿病周围神经病变(OR=1.93,95%CI 1.57-2.37)和糖尿病视网膜病变(OR=1.26,95%CI 1.01-1.57)。用于预测成年 T2D 患者 LEAD 和中重度 LEAD 风险的列线图的总受试者工作特征曲线下面积分别为 0.793(95%CI 0.720,0.824)和 0.736(95%CI 0.678,0.795)。开发的列线图简单易用,可初步预测中国 50 岁以上 T2D 患者的 LEAD 风险和程度。该列线图具有一定的准确性,为预测 LEAD 的发生和进展提供了临床依据。