| Lower extremity arterial disease (LEAD) also called peripheral vascular disease (PVD) or peripheral arterial disease (PAD) is one of the common chronic diabetic complications. The occurrence rate of lower extremity arterial disease in diabetic crowds is twenty times higher than that in non-diabetic ones and eight percent patients have had lower extremity arterial diseases when they were diagnosed by type 2 diabetes mellitus. It is of significance to discover and prevent PAD earlier because it is the major reason of diabetic foot ulcer,lower amputation ,especially higher amputation and once-again amputation. Clinically, there are many methods to diagnose and evaluate the function of peripheral vascular for PAD patients, such as angiography, transcutaneous oxygen tension (TcPO2) and so on. However, most of them are expensive, complicated and harmful. It is the ankle-brachial index (ABI) that will be cheap, simple and do no harm to patients. ABI is the ratio of the resting systolic pressure in the arteries of the ankle to that of the brachial artery. Measuring ABI can help diagnose whether the patients with type 2 diabetes have PAD.The main purpose of this paper is to obtain the diagnosis of peripheral artery disease (PAD) and its relative risk factors by investigating the ankle-brachial index (ABI) of the patients with type 2 diabetes. The Method we will use is as following:There are 78 patients with type 2 diabetes who are selected in our hospital from March, 2006 to March, 2007. Among these patients who are at the age from 43 to 77(58.04±8.41), 40 are males and 38 are females. All the patients meet the standard of diagnosis and classification made by ADA in 1997. ABI of the 78 patients are measured and according to the result, the patients are divided into the PAD group(ABI≤0.9) and the NPAD group(ABI>0.9). Among the PAD group, there are 22 males and 18 females whose mean age is 60.83±10.09 and course of disease is 9.35±3.74 years while among the NPAD group ,there are 18 males and 20 females whose mean age is 56.00±7.50 and course of disease is 5.07±2.61 years.All patients in the rest are measured height, weight, blood pressure, fasting and postprandial glucose levels, serum insulin, cholesterol-total, serum triglycerides, serum LDL cholesterol ,serum HDL cholesterol and HbA1C. We also calculate BMI (calculated as weight in kilograms divided by height in meters squared), Insulin sensitiveness index(ISI) = 1/FBG×FIN and Insulin resistance index (HOMA-IR = FBG×FIN/22.5). Measure data is denoted by( x±s)where x is mean value and s is standard deviation. The case of P <0.05 have statistical meaning. T-test, x2-test and stepwise regression analysis are used in this paper.We get the following results:1. Among 78 patients with type 2 diabetes mellitus, 40 (51.28 percent) have ABI no more than 0.9. By further colorful ultrasonic test of blood vessels of lower limbs, 37 patients are diagnosed to have atherosclerosis and carotid straitness. 2.Through comparing the data of the two groups, The differences in sex(P=0.5), BMI(P=0.837), cholesterol-total(P=0.211), serum HDL cholesterol(P=0.628), Insulin sensitiveness index (P=0.089) and Insulin resistance index(P=0.467)have no statistical meaning because P>0.05. On the contrast, the differences in age(P=0.019), course of disease(P=0.048), fasting(P=0.045) and postprandial glucose levels(P<0.01), serum triglycerides(P<0.01), serum LDL cholesterol(P=0.002), systolic blood pressure(p=0.005) , diastolic blood pressure(P=0.014) and HbA1C(P<0.01) have statistical meaning. 3. Through the multiple linear regression(α=0.05)which use ABI as dependent variable and age, blood pressure, fasting and postprandial glucose levels, serum triglycerides, HbA1C and serum LDL cholesterol as the independent variables, the most relative factors are course of disease, serum triglycerides, serum LDL cholesterol and HbA1C. Regression equation is ABI=2.122-0.014病程-0.101TG-0.098LDL-C-0.090HbA1C . The factors have P of 0.014, 0.001, 0.002, 0.001 respectively.We get the conclusion that ABI is a cheap, no-harmful credible measurement of PAD and should be applied in clinic. Course of disease , TG ,LDL-C and HbA1C are the most relative factors of ABI.
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