Gašparini Dora, Zuljani Anamaria, Wensveen Felix M, Turk Wensveen Tamara
Center for Diabetes, Endocrinology and Cardiometabolism, Special Hospital for Medical Rehabilitation of Cardiac, Pulmonary and Rheumatic diseases Thalassotherapia Opatija, Maršala Tita 188/1, 51410 Opatija, Croatia.
Department of Histology and Embryology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia.
Int J Cardiol Heart Vasc. 2023 Nov 26;49:101308. doi: 10.1016/j.ijcha.2023.101308. eCollection 2023 Dec.
Peripheral arterial disease (PAD) reduces functional capacity and raises cardiovascular risks, but underdiagnosis is common, resulting in less comprehensive care than other cardiovascular conditions. While diabetes has long been viewed as a key risk factor for PAD, recent studies indicate that its impact is influenced by the presence of concurrent cardiovascular risk factors. The aim of this study is to elucidate the intricate relationship between the prevalence of PAD, diabetic complications, and cardiovascular risk factors among asymptomatic patients with type 2 diabetes mellitus (T2DM).
Ninety-one patients with T2DM and no symptoms or previous diagnosis of PAD were recruited from the outpatient diabetic clinic. Clinical data were extracted from electronic medical records, and the screening for PAD was conducted using MESI mTABLET.
Screening for PAD among asymptomatic individuals with T2DM revealed that 5.49 % of patients exhibit a low ankle-brachial index (ABI). Patients who had previously experienced major adverse cardiovascular events or exhibited albuminuria displayed lower ABI values. Furthermore, a striking 45.05 % of the participants displayed an abnormally high carotid-femoral pulse wave velocity (cfPWV) value, with elevated PWV values correlating with advanced age and longer diabetes duration.
The prevalence of elevated cfPWV is more pronounced than that of decreased ABI in T2DM patients with asymptomatic PAD and is associated with older age and longer diabetes duration, therefore measurement of both ABI and PWV is crucial for the cardiovascular risk assessment protocol for patients with T2DM and timely PAD diagnosis.
外周动脉疾病（PAD）会降低功能能力并增加心血管风险，但诊断不足的情况很常见，导致其治疗不如其他心血管疾病全面。长期以来，糖尿病一直被视为PAD的关键危险因素，但最近的研究表明，其影响受并发心血管危险因素的存在影响。本研究的目的是阐明2型糖尿病（T2DM）无症状患者中PAD患病率、糖尿病并发症和心血管危险因素之间的复杂关系。
从门诊糖尿病诊所招募91例无PAD症状或既往诊断的T2DM患者。从电子病历中提取临床数据，并使用MESI mTABLET进行PAD筛查。
对T2DM无症状个体进行PAD筛查发现，5.49%的患者踝臂指数（ABI）较低。既往经历过重大不良心血管事件或出现蛋白尿的患者ABI值较低。此外，45.05%的参与者颈动脉-股动脉脉搏波速度（cfPWV）值异常高，PWV值升高与高龄和糖尿病病程较长相关。
在无症状PAD的T2DM患者中，cfPWV升高的患病率比ABI降低的患病率更明显，且与高龄和糖尿病病程较长相关，因此测量ABI和PWV对于T2DM患者的心血管风险评估方案和及时诊断PAD至关重要。
