Assem Maha, Mousa Shrook, Abdelhamid Alaa, Amin Samar, Elsamadony Ayman, El-Sebaee Eman, Saif Aasem, Elsawy Shereen
Internal Medicine Department, Cairo University, Giza, Egypt.
Vascular Laboratory, Cairo University, Giza, Egypt.
J Community Hosp Intern Med Perspect. 2021 Mar 23;11(2):216-219. doi: 10.1080/20009666.2021.1877906.
: The aim of this study was to assess the prevalence of micro- and macrovascular disease in Egyptian patients with diabetes mellitus (DM) and peripheral arterial disease (PAD). : The study included 161 Egyptian patients with DM and PAD (91.3% had type 2 DM and 67.1% were females). Mean diabetes duration was 14.2 ± 5.2 years. Full history, clinical and fundus examination as well as laboratory investigations were done. PAD was diagnosed through assessment of ankle/brachial index (ABI) by Doppler ultrasonography. : ABI was <0.9 in 33.5% and >1.3 in 66.5% of patients. A significant positive correlation was found between abnormal ABI and diabetes duration, ischemic heart disease (IHD), diabetic retinopathy and neuropathy, foot ulcers, elevated blood pressure (BP), creatinine, urine albumin/creatinine ratio (ACR) and triglycerides and a significant negative correlation with HDL. Multivariate regression analysis revealed that the independent predictors for PAD in patients with ABI< 0.9 were neuropathy, creatinine, triglyceride, LDL, urine ACR and low HDL, and in patients with ABI >1.3 were IHD, neuropathy, elevated diastolic BP and triglyceride. : The risk of micro- and macrovascular disease is high in Egyptian patients with diabetes and PAD. Early diagnosis and good control of risk factors could reduce PAD progression.
本研究旨在评估埃及糖尿病(DM)合并外周动脉疾病(PAD)患者微血管和大血管疾病的患病率。该研究纳入了161例埃及DM合并PAD患者(91.3%为2型糖尿病,67.1%为女性)。糖尿病平均病程为14.2±5.2年。进行了全面的病史、临床和眼底检查以及实验室检查。通过多普勒超声检查评估踝臂指数(ABI)来诊断PAD。33.5%的患者ABI<0.9,66.5%的患者ABI>1.3。发现异常ABI与糖尿病病程、缺血性心脏病(IHD)、糖尿病视网膜病变和神经病变、足部溃疡、血压(BP)升高、肌酐、尿白蛋白/肌酐比值(ACR)和甘油三酯之间存在显著正相关,与高密度脂蛋白(HDL)存在显著负相关。多因素回归分析显示,ABI<0.9的患者中,PAD的独立预测因素为神经病变、肌酐、甘油三酯、低密度脂蛋白(LDL)、尿ACR和低HDL;ABI>1.3的患者中,PAD的独立预测因素为IHD、神经病变、舒张压升高和甘油三酯。埃及糖尿病合并PAD患者发生微血管和大血管疾病的风险很高。早期诊断和良好控制危险因素可减少PAD的进展。