[Analysis of peripheral arterial obstructive disease related factors among diabetic population aged > or = 50].
OBJECTIVE
To analyze the peripheral arterial obstructive disease (PAD) related factors among diabetic population aged > or = 50 in China.


METHODS
The clinical data of 1397 diabetic patients aged > or = 50 with at least one of the following risk factors: smoking, hypertension, and hyperlipidemia, from 15 Class III Grade A hospitals in 7 major cities of China were collected. Diagnosis of PAD was based on the ankle brachial index (ABI) < 0.9, and diagnosis of arteriosclerosis was based on pulse wave velocity (PWV) > 1400 cm/s. Regression studies were made to analyze the relations among PAD and various risk factors: age, sex, body mass index (BMI), smoking, hypertension, hyperlipidemia, history of cerebral vascular disease (CVD), history of ischemia heart disease (IHD) etc.


RESULTS
The current prevalence rate of PAD was 19.47% among the 1397 patients, 18.3% (122/664) among the male patients, and 20.4% (150/733) among the female patients. The prevalence of PAD in the patients aged > or = 70 was as high as 31.9%. The duration of diabetes course was positively correlated with the prevalence of PAD (chi2 = 11.9, P = 0.0026). The ABI abnormality rate was 15.78% among those with a diabetic course of 5 years and was 23.84% among those with a diabetic course of 10 years. The abnormal ABI rate of the patients with CVD was 30.57%, significantly higher than that of hose without CVD (17.29%, chi2 = 21.49, P < 0.0001). The abnormal ABI rate of the patients with IHD was 24.64%, significantly higher than that of the patients without IHD (18.20%, chi2 = 5.85, P = 0.0155). The HbA1c value of the PAD patients was significantly higher than that of the patients without PAD (chi2 = 5.10, P = 0.0239) Odd risk analysis showed that age increase of 10 years increased the PAD risk by 1.64 times (OR = 1.6444, P = 0.0001). The PAD risk of the smokers was 1.68 times higher than that of the non-smokers (OR = 1.6852, P = 0.0001). Increase of 10 mm Hg in systolic blood pressure (SBP) increased the PAD risk by 1.19 times (OR = 1.1926, P = 0.01). The PAD risk of the patients with abnormal HbAlc was 2.44 times higher than that of the patients with normal HbA1c (OR = 2.4473, P = 0.0001). One-year's increase of the hypertension course increased the PAD risk by 1.02 times (OR = 1.0194, P = 0.03). Logistic analysis indicated that the relations among PWV and the risk factors were almost the same among ABI abnormality and the risk factors.


CONCLUSIONS
Approximately one fifth of diabetic patients aged > or = 50 in China suffer from PAD. Age, course of diabetes, blood glucose level, SBP, IHD, and CVD are risk factors for PAD. Early intervention and treatment of hypertension and hyperglycemia, and quitting smoking are important in reducing the occurrence of PAD. ABI and PWV are not only diagnostic means for PAD, but also alarm guide indexes for cerebral vascular disease (CVD).
Guan
Heng
H
Department of Vascular Surgery, Peking Union Medical College Hospital, CAMS&PUMC, Beijing, China.
Liu
Zhi-Min
ZM
Li
Guang-Wei
GW
Guo
Xiao-Hui
XH
Xu
Zhang-Rong
ZR
Zou
Da-Jin
DJ
Xing
Hui-Li
HL
Liu
Wei
W
Sheng
Zheng-Yan
ZY
Tian
Hao-Ming
HM
Zhu
Da-Long
DL
Yu
De-Min
DM
Zhuang
Wei-Te
WT
Chen
Lu-Lu
LL
Weng
Jian-Ping
JP
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001162:Arteriosclerosis Obliterans / Q000453:epidemiology* / Q000209:etiology; D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects