Akinyosoye Gbenga, Akinola Ibironke Jadesola, Lamina Amotunur Bukola, Akinsola Clement Morakinyo
Department of Paediatrics, Lagos State University Teaching Hospital, Lagos, Nigeria.
Department of Paediatrics and Child Health, Lagos State University College of Medicine, Lagos, Nigeria.
J Pediatr Endocrinol Metab. 2023 Mar 21;36(4):378-383. doi: 10.1515/jpem-2022-0504. Print 2023 Apr 25.
The study aimed to determine the prevalence of PAD in children with T1DM and to correlate PAD with clinical characteristics in children with T1DM.
A comparative cross-sectional study was conducted involving 90 subjects (forty-five with T1DM and 45 apparently healthy comparative subjects that were matched for age and gender). Systolic blood pressure was measured in all limbs using the pocket Doppler machine (Norton Doppler scan machine). Ankle brachial index (ABI) was calculated as a ratio of ankle to arm systolic blood pressure. Peripheral arterial disease was defined as ABI less than 0.9.
The prevalence of PAD was significantly higher in children with T1DM than in the matched comparison group (37.8% vs. 6.7%, p<0.001). Average values of waist circumference, hip circumference, weight, height and body mass index were comparable in subjects with TIDM and the comparison group (p>0.05). Subjects with PAD had a poorer glucose control evident by higher average values of glycated haemoglobin than those without PAD (13.47 ± 3.2% vs. 8.16 ± 2.3%, p<0.001). There is a strong negative correlation between ABI scores and glycated haemoglobin among subjects with T1DM (r=-0.626, p<0.001).
With these findings, it is recommended that screening for PAD in children who have T1DM and poor glycaemic control should be done early to prevent cardiovascular complications before they arise.
本研究旨在确定1型糖尿病(T1DM)患儿外周动脉疾病(PAD)的患病率,并将PAD与T1DM患儿的临床特征进行关联分析。
进行了一项比较性横断面研究,纳入90名受试者(45名T1DM患儿和45名年龄及性别匹配的明显健康的对照受试者)。使用袖珍多普勒仪(诺顿多普勒扫描仪)测量所有肢体的收缩压。计算踝臂指数(ABI),即踝部与臂部收缩压之比。外周动脉疾病定义为ABI小于0.9。
T1DM患儿中PAD的患病率显著高于匹配的对照组(37.8%对6.7%,p<0.001)。T1DM受试者和对照组的腰围、臀围、体重、身高和体重指数的平均值相当(p>0.05)。与无PAD的受试者相比,有PAD的受试者糖化血红蛋白平均值更高,血糖控制更差(13.47±3.2%对8.16±2.3%,p<0.001)。在T1DM受试者中,ABI评分与糖化血红蛋白之间存在强烈的负相关(r=-0.626,p<0.001)。
基于这些发现,建议对血糖控制不佳的T1DM患儿尽早进行PAD筛查,以预防心血管并发症的发生。