踝肱指数联合血清25-羟维生素D水平对2型糖尿病下肢血管病变的诊断价值

Diagnostic value of ankle-brachial index combined with serum 25-hydroxyvitamin D level in lower extremity vascular lesions of type 2 diabetes mellitus

目的 探讨踝肱指数(ABI)联合血清25-羟维生素D[25(OH)D]水平对2型糖尿病下肢血管病变的诊断价值。方法 选择2018年7月至2021年1月安徽省亳州市人民医院收治的179例2型糖尿病患者,根据是否发生下肢血管病变将其分为未病变组(106例)与病变组(73例)。分析2型糖尿病患者发生下肢血管病变的影响因素,分析ABI联合血清25(OH)D水平对其的诊断价值。结果 病变组年龄、糖化血红蛋白、低密度脂蛋白胆固醇高于非病变组,白蛋白、ABI、血清25(OH)D水平低于非病变组(P<0.05)。多因素分析结果显示,年龄(OR=2.843,95%CI:1.250~6.468)、糖化血红蛋白(OR=3.056,95%CI:1.343~6.951)、ABI (OR=2.724,95%CI:1.197~6.196)、血清25(OH)D水平(OR=3.979,95%CI:1.749~9.051)为2型糖尿病患者发生下肢血管病变的影响因素(P<0.05)。ABI、血清25(OH)D水平联合预测2型糖尿病下肢血管病变的曲线下面积高于二者单独预测(P<0.05)。结论 ABI联合血清25(OH)D水平对2型糖尿病患者发生下肢血管病变具有一定的诊断价值,临床中应予以重视。

Objective To investigate the diagnostic value of ankle-brachial index(ABI) combined with serum 25-hydroxyvitamin D(25 [OH]D) level in lower extremity vascular lesions of type 2 diabetes mellitus.Methods A total of 179 patients with type 2 diabetes mellitus admitted to Bozhou People's Hospital in Anhui Province from July 2018 to January 2021 were selected and divided into non-lesion group(106 cases) and lesion group(73 cases) according to whether they had lower extremity vascular lesions.The influencing factors of lower extremity vascular lesions in patients with type 2 diabetes mellitus and the diagnostic value of ABI-combined with serum 25(OH) D levels were analyzed.Results The age,glycosylated hemoglobin,and lowdensity lipoprotein-cholesterol in the lesion group were higher than those in the non-lesion group,and the albumin,ABI,and serum 25(OH) D levels were lower than those in the non-lesion group(P<0.05).Multivariate analysis showed that age(OR=2.843,95%CI:1.250-6.468),glycosylated hemoglobin(OR=3.056,95%CI:1.343-6.951),ABI(OR=2.724,95%CI:1.197-6.196),and serum 25(OH) D level(OR=3.979,95%CI:1.749-9.051) were the influencing factors of lower extremity vascular lesions in patients with type 2 diabetes mellitus(P<0.05).The area under the curve of the combination of ABI and serum 25(OH) D level in predicting lower extremity vascular lesions of type 2diabetes mellitus was higher than that of ABI and serum 25(OH) D level alone(P<0.05).Conclusion ABI combined with serum 25(OH) D level has a certain diagnostic value for lower extremity vascular lesions in patients with type 2 diabetes mellitus,which should be paid attention to in clinical practice.