2型糖尿病患者合并下肢动脉疾病多因素分析

Multi-Factor Analysis of Lower Extremity Arterial Disease in Patients with Type 2 Diabetes

目的:探讨2型糖尿病(T2DM)患者合并下肢动脉病变程度的影响因素。方法:对455例住院的T2DM患者行下肢多普勒超声检查,根据下肢动脉超声检查结果分为对照组109例、轻度狭窄组(狭窄<30%)113例、中度狭窄组(30%≤狭窄<70%)118例和重度狭窄组(≥70%组)115例,分析各组下肢动脉疾病程度及其影响因素。结果:重度狭窄组的年龄、病程、体质指数(BMI)、腰围(WC)、腰臀比(WHR)、腰围身高比(WHtR)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、糖化血红蛋白(HbA1c)高于其他3组,差异有统计学意义(P<0.01或P<0.05),中、重度狭窄组的高密度脂蛋白胆固醇(HDL-C)低于轻度狭窄组和对照组,差异有统计学意义(P<0.01或P<0.05);下肢动脉病变与WHtR、HbA1c、病程、年龄、LDL-C、WC、SBP呈正相关(P<0.01),与HDL-C呈负相关(P<0.01);多项Logistic回归分析显示,WHtR、HbA1c、LDL-C升高均为下肢动脉病变发生的危险因素(P<0.01或P<0.05),HDL-C升高为下肢动脉的保护因素(P<0.05)。结论:WHtR可能为预测T2DM患者合并外周动脉疾病的一项经济、简便、有效的人体测量学指标。

Objective：To explore the risk factors for the severity of lower extremity arterial disease in patients with type 2 diabetes （T2DM）.Methods：Four hundred and fifty-five hospitalized T2DM patients were divided into four groups according to color Doppler ultrasound examination in lower limb,including 109 patients without stenosis （control group）,113 patients with stenosis30% （mild stenosis group）,118 patients with 30%≤stenosis70% （moderate stenosis group） and 115 patients with stenosis≥70% （severe stenosis group）.The risk factors were analysed in subjects of groups.Results：There were significantly higher values of age,course of disease,body mass index （BMI）,waist circumference （WC）,waist-hip ratio （WHR）,waist-height ratio （WHtR）,triglyceride （TG）,total cholesterol （TC）,low-density lipoprotein （LDL-C）,systolic blood pressure （SBP） and glycosylated hemoglobin （HbA1c） in patients of severe stenosis group than those of other groups （P 0.01 or P 0.05）.The level of high-density lipoprotein （HDL-C） was lower in patients of moderate stenosis group and severe stenosis group than that of mild stenosis group and control group （P 0.01 or P 0.05）.There was a positive correlation between lower extremity arterial diseases and WHtR,HbA1c,course of disease,age,LDL-C,WC and SBP （P 0.01）,but a negative correlation between lower extremity arterial diseases and HDL-C.Logistic regression analysis showed that values of WHtR,HbA1c and LDL-C were independent risk factors for the severity of angiographic peripheral arterial disease （P 0.01 or P 0.05）.The increased level of HDL-C was the protective factor for lower extremity arterial diseases （P 0.05）.Conclusion：WHtR might be an easy and efficient anthropometric index for prognosis of peripheral arterial disease in patients with T2DM.