Solanki Jayesh Dalpatbhai, Shah Axat Pragnesh, Lalwani Nisha, Trivedi Bansi Janakbhai, Savani Avan Ashokbhai, Sojitra Krupali Parshottambhai
Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India.
Department of Orthopedics, Smt NHL Municipal Medical College, Ahmedabad, Gujarat, India.
J Family Med Prim Care. 2025 Feb;14(2):687-692. doi: 10.4103/jfmpc.jfmpc_1168_24. Epub 2025 Feb 21.
Among type 2 diabetics (T2D), macrovascular complication lower limb Peripheral Arterial Disease (PAD) and microvascular complication Diabetic Peripheral Sensory Neuropathy (DPSN) have scarcely studied concordance and their association with obesity. Qualitative and general body fat parameters give a complete picture of obesity. We studied the association of vibration perception threshold (VPT)-based DSPN and ankle brachial pressure index (ABPI))-based PAD, and the effect of obesity on them, in T2Ds.
A cross-sectional study was done on 152 under-treatment T2Ds. Bio-esthesiometer-based VPT from the sole of each foot and VersaDop-based ABPI from all limbs were assessed. Prevalence of DSPN (VPT ≥25) and PAD (ABPI ≤0.9) was measured and compared for concomitance. The odds ratio was used for testing association and multiple linear regressions were accomplished for predictors of VPT and ABPI taking value < 0.05 as statistically significant.
T2Ds had a mean age of 53 years, a mean duration of 67 months, and 48% glycemic control. The prevalence of abnormal VPT and ABPI was 64% and 23%, respectively. VPT-based subgroups do not defer significantly from ABPI and vice versa. Obesity was associated with only abnormal ABPI (visceral > general). Odd's ratio for neuropathy with vasculopathy was insignificant while VPT and ABPI had differences in significant predictors.
T2Ds having 64% neuropathy and 23% vasculopathy had one-third concomitance but lack of association and different predictors for each. Vasculopathy not neuropathy was associated with obesity; visceral more than general; suggesting scope for its rectification. It suggests different progression of these complications, despite some cross-talk between them.
在2型糖尿病患者（T2D）中，大血管并发症下肢外周动脉疾病（PAD）和微血管并发症糖尿病周围感觉神经病变（DPSN）之间的一致性及其与肥胖的关联鲜有研究。定性和总体身体脂肪参数能全面反映肥胖情况。我们研究了基于振动觉阈值（VPT）的DSPN和基于踝臂压力指数（ABPI）的PAD之间的关联，以及肥胖对T2D患者中它们的影响。
对152名正在接受治疗的T2D患者进行了一项横断面研究。评估了每只脚底基于生物感觉测量仪的VPT以及所有肢体基于VersaDop的ABPI。测量并比较了DSPN（VPT≥25）和PAD（ABPI≤0.9）的患病率及其并存情况。采用优势比检验关联性，并进行多元线性回归分析以确定VPT和ABPI的预测因素，以P值<0.05为具有统计学意义。
T2D患者的平均年龄为53岁，平均病程为67个月，血糖控制率为48%。异常VPT和ABPI的患病率分别为64%和23%。基于VPT的亚组与基于ABPI的亚组之间差异不显著，反之亦然。肥胖仅与异常ABPI相关（内脏脂肪>总体脂肪）。神经病变与血管病变的优势比无统计学意义，而VPT和ABPI在显著预测因素方面存在差异。
患有64%神经病变和23%血管病变的T2D患者中有三分之一同时存在这两种病变，但它们之间缺乏关联性且各自具有不同的预测因素。血管病变而非神经病变与肥胖相关；内脏脂肪比总体脂肪更相关；这提示了纠正肥胖的可能性。这表明尽管这些并发症之间存在一些相互影响，但它们的进展情况不同。
