累积代谢因素暴露值与2型糖尿病患者下肢血管病变进展的相关性

犹梅; 刘玉双; 杨萍; 黎黎; 杨若梅; 李强; 周晴; 李英莎; 祝之明; 闫振成

doi:10.16016/j.2097-0927.202106201

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累积代谢因素暴露值与2型糖尿病患者下肢血管病变进展的相关性

临床医学 | 更新时间：2026-01-09

- 累积代谢因素暴露值与2型糖尿病患者下肢血管病变进展的相关性
- Correlation of cumulative exposure to metabolic factors with progression of lower extremity arterial disease in type 2 diabetic patients
- 陆军军医大学学报 2022年44卷第5期页码：469-475
- 作者机构：
  
  400042 重庆，陆军特色医学中心高血压内分泌科，代谢性血管病重庆市重点实验室，全军高血压代谢病中心，重庆市高血压研究所
- 作者简介：
  
  [ 闫振成，E-mail：zhenchengyan@sina.com YAN Zhencheng; E-mail: zhenchengyan@sina.com
- 基金信息：
  
  重庆市自然科学基金面上项目(CSTC2019jcyj-msxmX0152);陆军特色医学中心课题(2019CXLCB008)
- DOI：10.16016/j.2097-0927.202106201
  中图分类号： R181.32;R543.5;R587.2
- 收稿：2021-06-25，
  
  修回：2021-09-17，
  
  纸质出版：2022-03-15
- 稿件说明：
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犹梅, 刘玉双, 杨萍, 等. 累积代谢因素暴露值与2型糖尿病患者下肢血管病变进展的相关性[J]. 陆军军医大学学报, 2022,44(5):469-475.

Mei YOU, Yushuang LIU, Ping YANG, et al. Correlation of cumulative exposure to metabolic factors with progression of lower extremity arterial disease in type 2 diabetic patients[J]. Journal of Army Medical University, 2022, 44(5): 469-475.
犹梅, 刘玉双, 杨萍, 等. 累积代谢因素暴露值与2型糖尿病患者下肢血管病变进展的相关性[J]. 陆军军医大学学报, 2022,44(5):469-475. DOI： 10.16016/j.2097-0927.202106201.

Mei YOU, Yushuang LIU, Ping YANG, et al. Correlation of cumulative exposure to metabolic factors with progression of lower extremity arterial disease in type 2 diabetic patients[J]. Journal of Army Medical University, 2022, 44(5): 469-475. DOI： 10.16016/j.2097-0927.202106201.

摘要

目的

探讨累积代谢因素暴露值与2型糖尿病患者下肢血管病变(lower extremity arterial disease，LEAD)进展的相关性。

方法

回顾性分析2013年1月至2021年3月于本科连续3年入院的157例2型糖尿病患者资料，根据随访期间踝肱指数(ankle brachial index

ABI)下降情况，分为LEAD进展组(

=63)和LEAD无进展组(

=94)，采用独立样本

检验或非参数检验对比分析2组间人口学基本特征、实验室检查的基础值和累积暴露值，采用COX回归模型分析LEAD进展的独立危险因素。

结果

与LEAD无进展组比较，LEAD进展组年龄更大，糖尿病和高血压病程更长，糖尿病脑血管、心血管和周围神经病变患病率更高，调脂药、抗血小板药用药率更高；LEAD进展患者的基础ABI、终末ABI和累积ABI均更低，基础收缩压、舒张压均更高，累积收缩压、舒张压、总胆固醇、空腹血糖、糖化血红蛋白、超敏C反应蛋白、微量白蛋白、尿白蛋白肌酐比值暴露值均更高(

0.05)。多元COX回归分析提示糖尿病脑血管病变(

=2.448，95%

：1.436~4.173，

=0.001)、糖尿病周围神经病变(

=2.237，95%

：1.312~3.812，

=0.003)、累积收缩压暴露值(

=1.128，95%

：1.067~1.193，

0.001)、累积尿白蛋白肌酐比值暴露值(

=1.015，95%

：1.006~1.025，

=0.001)为LEAD进展的独立危险因素。

结论

糖尿病脑血管病变、糖尿病周围神经病变、高累积收缩压暴露值和高尿白蛋白肌酐比值暴露值是2型糖尿病患者LEAD进展的独立危险因素。

Abstract

Objective

To investigate the correlation between cumulative exposure to metabolic factors and progression of lower extremity arterial disease (LEAD) in patients with type 2 diabetes mellitus (T2DM).

Methods

Clinical data of 157 T2DM patients who were hospitalized to our department for 3 consecutive years from January 2013 to March 2021 were collected and retrospectively analyzed. According to decline in ankle brachial index (ABI) during follow-up

the patients were divided into LEAD progression group (

=63) and LEAD non-progression group (

=94). Independent sample

-test or non-parametric test was adopted to compare and analyze the clinical baseline characteristics

basic values of laboratory tests and cumulative exposure values of metabolic factors between the 2 groups; Cox regression model was employed to explore the independent risk factors for LEAD progression.

Results

As compared with the LEAD non-progression group

the LEAD progression group had older age

longer history of diabetes and hypertension

higher prevalence of diabetic cerebrovascular disease

cardiovascular disease and peripheral neuropathy

and higher usages of medications

including lipid-regulating and anti-platelet drugs. In the LEAD progression patients

the baseline

terminal and cumulative ABI were lower

while the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher (

0.05)

and the cumulative exposure values of SBP

DBP

total cholesterol

fasting plasma glucose

hemoglobin Alc

hypersensitive C-reactive protein

microalbumin and urinary albumin creatine ratio (UACR) were all elevated when compared with the LEAD non-progression group (

0.05). Multivariate Cox regression analysis indicated that diabetic cerebrovascular diseases (

=2.448

95%

: 1.436~4.173

=0.001)

peripheral neuropathy (

=2.237

95%

: 1.312~3.812

=0.003)

cumulative exposure value of SBP (

=1.128

95%

: 1.067~1.193

0.001) and that of UACR (

=1.015

95%

: 1.006~1.025

=0.001) were independent risk factors for LEAD progression.

Conclusion

Diabetic cerebrovascular disease

peripheral neuropathy

and increased cumulative exposure values of SBP and UACR are independent risk factors for progression of LEAD in T2DM patients.

关键词

Keywords

references

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