Abstract

Atherosclerosis is a progressive asymmetrical systemic disease that progresses faster in patients with diabetes comorbidity. Therefore, type 2 diabetic (T2DM) patients who have a high risk of, or have already detected, early atherosclerosis should be treated aggressively to prevent premature mortality. We hypothesised that subclinical atherosclerosis is predictable with the ankle-brachial index (ABI). There are currently only a few studies to indicate which specific value of ABI can predict atherosclerosis in the carotid artery. Our study aimed to examine ABI ≤ 1.1 ability to predict ultrasound-visualised atherosclerosis in carotid arteries in patients with T2DM, who had not been previously diagnosed with atherosclerosis. A population-based cross-sectional multicentric study was performed in 216 participants (mean age 59 ± 8 years). Carotid artery intima-medial thickness (IMT) ≥1 mm ± plaque was defined as a marker for subclinical atherosclerosis and was compared with ABI. Mean duration of T2DM was 7.05 ± 6.0 years. Atherosclerosis in the carotid artery was found in 96 (44%) patients, with no significant differences between genders (47 vs 53%, p = .206). ABI ≤1.1 was associated with the carotid artery mean IMT ≥1 mm (p = .037), plaque (p = .027) and IMT ≥1 mm ± plaque (p = .037). The association between ABI ≤ 1.1 and IMT ≥ 1 mm ± plaque remained significant after adjustment for risk factors and age >50 years. Observations demonstrated that ABI ≤ 1.1 could be an indicator of subclinical atherosclerosis for T2DM male patients over 50 years old.

摘要

动脉粥样硬化是一种进行性不对称的全身性疾病，在糖尿病合并症患者中进展更快。因此，应积极治疗具有高风险或已经检测到早期动脉粥样硬化的 2 型糖尿病 (T2DM) 患者，以防止过早死亡。我们假设亚临床动脉粥样硬化可以通过踝臂指数（ABI）来预测。目前只有少数研究表明 ABI 的哪个特定值可以预测颈动脉粥样硬化。我们的研究旨在检查 ABI ≤ 1.1 预测 T2DM 患者颈动脉中超声可视化动脉粥样硬化的能力，这些患者以前没有被诊断出患有动脉粥样硬化。对 216 名参与者（平均年龄 59 ± 8 岁）进行了一项基于人群的横断面多中心研究。颈动脉内膜中层厚度 (IMT) ≥1 mm ± 斑块被定义为亚临床动脉粥样硬化的标志物，并与 ABI 进行比较。T2DM 的平均持续时间为 7.05 ± 6.0 年。96 名（44%）患者发现颈动脉粥样硬化，性别间无显着差异（47% vs 53%，p = .206）。ABI ≤1.1 与颈动脉平均 IMT ≥1 mm ( p = .037)、斑块 ( p = .027) 和 IMT ≥1 mm ± 斑块 ( p = .037) 相关。ABI ≤ 1.1 和 IMT ≥ 1 mm ± 斑块之间的关联在调整风险因素和年龄 > 50 岁后仍然显着。观察表明，ABI ≤ 1.1 可能是 50 岁以上 T2DM 男性患者亚临床动脉粥样硬化的指标。