高踝肱指数与糖尿病微血管并发症的关系

Association of a high ankle brachial index with microvascular diseases of diabetes

目的 评估高踝肱指数（ABI）与糖尿病微血管并发症的关系并比较与低ABI对微血管并发症影响的差异.方法 对2003年9月至2010年6月在解放军第三○六医院糖尿病中心进行糖尿病慢性并发症筛查并行ABI测定的3293例2型糖尿病患者的病史资料及检查结果进行回顾分析.采用单因素和Logistic回归分析各组ABI与糖尿病微血管并发症的关系.结果 3060例患者ABI在正常范围,ABI＜0.7患者44例,ABI在0.7 ～0.9患者139例,ABI＞ 1.3患者50例.Logistic分析显示与ABI增高明显相关的因素是吸烟（OR：2.605；95％CI：1.458 ～4.656,P=0.001）和收缩压（OR：1.019；95％ CI：1.005～1.033,P=0.006）.ABI增高与糖尿病肾病、糖尿病周围神经病变和糖尿病视网膜病变无明显相关.结论 对于无糖尿病大血管病变的2型糖尿病患者,高ABI并非有更多的动脉粥样硬化危险因素,且糖尿病微血管并发症的发病率并不明显高于正常ABI患者.

Objective To evaluate the association of a high ankle brachial index （ABI） with microvascular diseases of diabetes and to compare its strength with that of a low ABI.Methods ABI was obtained in 3293 patients undergoing the screening of chronic complications at the Diabetic Center,No.306 Hospital of PLA during the period of September 2003 to June 2010.The patient profiles and laboratory data were reviewed.The associations of ABI with microvascular diseases of diabetes were determined by univariate and stepwise Logistic regression analysis. Results ABI was normalin 3060 patients. 44 had ABI measurements 〈0.7,139 had ABI measurements between 0.7 -0.9,and 50 had ABI measurements 〉1.3.Multivariate analysis indicated that the factors significantly associated with a high ABI were smoking （OR：2.605; 95% CI： 1.458 -4.656,P =0.001 ） and systolic blood pressure （OR： 1.019; 95% CI：1.005 - 1.033,P =0.006）.The conditions of nephropathy,neuropathy and retinopathy were not associated with a high ABI.Conclusion Diabetics with a high ABI carry not more adverse atherosclerotic risk factors and suffer no more severe microvascular diabetic complications than those with a normal ABI.