›› 2017, Vol. 37 ›› Issue (9): 1220-.doi: 10.3969/j.issn.1674-8115.2017.09.006

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Indicating value of lower extremity atherosclerotic disease ultrasound screening for cardiovascular diseases in type 2 diabetes patients#br#

HUA Xiao-han, LIU Ying-feng, ZENG Hui, ZHAO Jun-gong, ZHAO Jun, LIU Fang, JIA Wei-ping   

  1. Shanghai Clinical Medical Center of Diabetes; Shanghai Key Clinical Center of Metabolic Diseases; Shanghai Institute for Diabetes; Shanghai Key Laboratory of Diabetes; Department of Endocrinology and Metabolism, Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2017-09-28 Published:2017-10-10
  • Supported by:
    National Natural Science Foundation of China, 81270397; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20152232

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Abstract: Objective · To verify the indicating value of the simple screening of lower extremity atherosclerosis artery disease (LEAD) by lower extremity arterial ultrasound examination for coronary atherosclerotic heart disease (CAD) in patients with type 2 diabetes.  Methods · A total of 606 type 2 diabetes patients were enrolled. Their clinical data and biochemical parameters (hepatorenal function, glycometabolism, tumor markers) were collected. All patients were undertaken lower extremity vascular ultrasound and CT angiography (CTA) scan for coronary artery disease. According to the results of lower extremity ultrasound, patients were divided into two groups, patients with LEAD group (n=318) and patients without LEAD group (n=288). According to the history of coronary CTA or percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA), the patients were divided into CAD group (n=280) and non-combined CAD group (n=326). The prevalence of CAD in different LEAD groups was compared and their relationship was analyzed.  Results · The degree of LEAD was proportional to the prevalence of CAD. Both of the prevalences of CAD in group with arterial stenosis >50% (81%) and group with plaque and stenosis<50% (63%) were significantly higher than that in group without plaque (29%) (P=0.021, P=0.015, respectively). Spearman analysis found that age, sex, duration of diabetes, systolic blood pressure, total cholesterol, LEAD, femoral artery intima-media thickness were positively correlated with CAD. However, high density lipoprotein cholesterol and glomerular filtration rate were negatively associated with CAD. Logistic regression analysis revealed that duration of diabetes, existence of LEAD were independent associated factors of CAD. After adjusting the confounding factors, odds ratio risk analysis showed the risk increased 4.818 times in patients with LEAD (OR=5.818, 95% CI 2.62712.888, P=0.000).  Conclusion · The evaluation of LEAD by ultrasound has an indicating value for CAD in type 2 diabetes patients.

Key words: type 2 diabetes, diabetic vascular complication, atherosclerosis, lower extremity atherosclerotic disease, coronary atherosclerotic heart disease