Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, China.
Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, China.
J Diabetes Res. 2022 Mar 29;2022:5064264. doi: 10.1155/2022/5064264. eCollection 2022.
Peripheral artery disease (PAD) in diabetic populations is a vital chronic disease all over the world due to its high morbidity and mortality. It is important to find early simple screening biomarkers and find residual risk factors that may provide a new target for prevention and treatment of PAD in diabetic patients besides traditional cardiometabolic risk factors.
We performed a cross-sectional retrospective study, and a total of 1671 T2DM participants were recruited. Receiver operating characteristic analysis, stepwise logistic regression analysis, points score system, and decision curve analysis were performed to assess the risk factors for PAD.
The prevalence of PAD in the study was 7.18% ( = 120). Compared to the participants with the lowest quartile of cystatin C (CysC), the risk of developing PAD in participants with the highest quartile of CysC increased 6.339-fold. The CysC was the superior indicators to distinguish participants with PAD from those without PAD, with an AUC of 0.716. Stepwise logistic regression analysis showed that CysC was independent risk factor for PAD besides traditional risk factors. Combined exposure to these traditional risk factors and CysC was associated with a stepwise increase in the risk of developing PAD and even increased 11.976-fold in participants with the highest quintiles of combined exposure score (CES) based on traditional risk factors and CysC compared to the participants with the lowest quintiles of CES.
CysC was associated with PAD independent of potential risk factors in diabetic populations. The CysC was a reliable marker for the early screening of PAD in diabetic patients besides traditional cardiometabolic risk factors.
糖尿病患者外周动脉疾病（PAD）是一种全球性的重要慢性疾病，其发病率和死亡率都很高。除了传统的心血管代谢危险因素外，寻找早期简单的筛查生物标志物和发现残余危险因素对于预防和治疗糖尿病患者的 PAD 非常重要。
我们进行了一项横断面回顾性研究，共纳入了 1671 名 2 型糖尿病患者。采用受试者工作特征曲线分析、逐步逻辑回归分析、评分系统和决策曲线分析来评估 PAD 的危险因素。
研究中 PAD 的患病率为 7.18%（=120）。与胱抑素 C（CysC）最低四分位数的参与者相比，CysC 最高四分位数的参与者发生 PAD 的风险增加了 6.339 倍。CysC 是区分 PAD 患者和非 PAD 患者的较好指标，AUC 为 0.716。逐步逻辑回归分析表明，除了传统危险因素外，CysC 也是 PAD 的独立危险因素。这些传统危险因素和 CysC 的联合暴露与 PAD 风险的逐步增加相关，与 CES 最低五分位的参与者相比，基于传统危险因素和 CysC 的联合暴露评分（CES）最高五分位的参与者发生 PAD 的风险甚至增加了 11.976 倍。
CysC 与糖尿病患者的 PAD 独立于潜在的危险因素有关。CysC 是除传统心血管代谢危险因素外，糖尿病患者 PAD 早期筛查的可靠标志物。
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