Beach K W, Bedford G R, Bergelin R O, Martin D C, Vandenberghe N, Zaccardi M, Strandness D E
Department of Surgery, University of Washington, Seattle 98195.
Diabetes Care. 1988 Jun;11(6):464-72. doi: 10.2337/diacare.11.6.464.
The prevalence of lower-extremity arterial occlusive disease (LEAOD), the progression of LEAOD, and the incidence of new LEAOD were determined by noninvasive method in 410 volunteers between the ages of 50 and 70 yr; 252 individuals had type II (non-insulin-dependent) diabetes, 158 were control subjects. LEAOD was monitored with the ankle/arm systolic blood pressure index in combination with Doppler arterial velocity waveform analysis. LEAOD was much more prevalent in the type II patients (22%, 55 of 252) than in the control subjects (3%, 4 of 158) (P less than .00001). The prevalence of risk factors for LEAOD was much higher in the type II patients, including elevated triglyceride, depressed high-density lipoprotein (HDL) cholesterol, hypertension, smoking, and elevated systolic blood pressure. In type II diabetic patients the incidence of new LEAOD over a 2-yr period (14%, 28 of 197) was lower than the incidence of LEAOD progression (87%, 45 of 52). Type II patients with LEAOD also had a high incidence of mortality (22%, 12 of 55) compared with those without LEAOD (4%, 8 of 197) (P less than .0005). A risk score including smoking history, duration of diabetes, depressed HDL cholesterol, total cholesterol, elevated systolic blood pressure, and low obesity index is related to LEAOD. After accounting for the effect of all of the risk factors, we suggest that type II diabetes contributes additional risk for LEAOD.
采用无创方法对410名年龄在50至70岁之间的志愿者进行了下肢动脉闭塞性疾病（LEAOD）的患病率、LEAOD的进展情况以及新发LEAOD的发病率测定；其中252人患有II型（非胰岛素依赖型）糖尿病，158人为对照对象。通过踝/臂收缩压指数结合多普勒动脉速度波形分析对LEAOD进行监测。LEAOD在II型患者中（22%，252人中的55人）比对照对象（3%，158人中的4人）更为普遍（P<0.00001）。II型患者中LEAOD危险因素的患病率要高得多，包括甘油三酯升高、高密度脂蛋白（HDL）胆固醇降低、高血压、吸烟以及收缩压升高。在II型糖尿病患者中，2年期间新发LEAOD的发病率（14%，197人中的28人）低于LEAOD进展的发病率（87%，52人中的45人）。与无LEAOD的II型患者（4%，197人中的8人）相比，患有LEAOD的II型患者死亡率也较高（22%，55人中的12人）（P<0.0005）。包括吸烟史、糖尿病病程、HDL胆固醇降低、总胆固醇、收缩压升高以及低肥胖指数在内的风险评分与LEAOD相关。在考虑了所有危险因素的影响后，我们认为II型糖尿病会增加LEAOD的额外风险。
