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2型糖尿病患者踝臂指数和颈动脉狭窄的危险因素

Risk Factors for Ankle Brachial Index and Carotid Artery Stenosis in Patients with Type 2 Diabetes.

作者信息

Đermanović Dobrota Vesna, Brkljačić Neva, Tičinović Ivančić Angelika, Čavlović Maja, Bulum Tomislav, Tomić Martina

机构信息

Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, 10000 Zagreb, Croatia.

Zagreb Country Public Health Institute, 10430 Samobor, Croatia.

出版信息

Metabolites. 2024 Jan 17;14(1):59. doi: 10.3390/metabo14010059.

Abstract

Type 2 diabetes mellitus (T2DM) significantly increases the risk of atherosclerotic cardiovascular disease. Ankle brachial index (ABI) and carotid artery stenosis are non-invasive indicators of generalized atherosclerosis. This study aimed to explore the risk factors for ABI and carotid artery stenosis and discover which factors simultaneously influence both conditions in T2DM. The study included a total of 101 patients with T2DM. ABI was performed via Doppler ultrasound, and both common carotid arteries were examined via ultrasound to obtain the percentage of carotid artery stenosis. A negative correlation was noted between the ABI and the percentage of carotid artery stenosis ( = 0.043). ABI correlated significantly negatively with waist circumference ( = 0.031), total cholesterol ( = 0.003), low-density lipoprotein (LDL) cholesterol ( = 0.003), and C-reactive protein (CRP) ( = 0.017), whereas the percentage of carotid artery stenosis correlated with the smoking habit ( = 0.017) and CRP ( = 0.042). The best model for predicting the ABI value (R = 0.195) obtained from stepwise regression analysis included waist circumference, LDL cholesterol, triglycerides, and CRP, while the best model for the percentage of the carotid artery stenosis (R = 0.112) included smoking and CRP. CRP influenced the ABI value with a negative parameter estimate of -0.008962 ( = 0.053) and the percentage of the carotid artery stenosis with a positive parameter estimate of 0.443655 ( = 0.006) relative to a one-unit change of it, presenting the negatively significant impact of CRP on the association between carotid artery stenosis and low ABI. Our results suggest that CRP is the most important risk factor that connects ABI and carotid artery stenosis, which are important non-invasive indicators of generalized atherosclerosis in T2DM.

摘要

2型糖尿病(T2DM)显著增加动脉粥样硬化性心血管疾病的风险。踝臂指数(ABI)和颈动脉狭窄是非侵入性的全身动脉粥样硬化指标。本研究旨在探讨ABI和颈动脉狭窄的危险因素,并发现哪些因素同时影响T2DM患者的这两种情况。该研究共纳入101例T2DM患者。通过多普勒超声测量ABI,并通过超声检查双侧颈总动脉以获得颈动脉狭窄百分比。ABI与颈动脉狭窄百分比之间呈负相关( = 0.043)。ABI与腰围( = 0.031)、总胆固醇( = 0.003)、低密度脂蛋白(LDL)胆固醇( = 0.003)和C反应蛋白(CRP)( = 0.017)显著负相关,而颈动脉狭窄百分比与吸烟习惯( = 0.017)和CRP( = 0.042)相关。逐步回归分析得出的预测ABI值的最佳模型(R = 0.195)包括腰围、LDL胆固醇、甘油三酯和CRP,而预测颈动脉狭窄百分比的最佳模型(R = 0.112)包括吸烟和CRP。相对于CRP一个单位的变化,其对ABI值的影响参数估计为 -0.008962( = 0.053),对颈动脉狭窄百分比的影响参数估计为0.443655( = 0.006),表明CRP对颈动脉狭窄与低ABI之间的关联具有显著负面影响。我们的结果表明,CRP是连接ABI和颈动脉狭窄的最重要危险因素,而ABI和颈动脉狭窄是T2DM患者全身动脉粥样硬化的重要非侵入性指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73a9/10820541/a1b86bf3ac8e/metabolites-14-00059-g001.jpg

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