Study On Prevalence And Correlates Of Lower Extremity Atherosclerotic Disease In Type 2 Diabetic Patients

Objectives: The study aimed to investigate the epidemic status and correlates of lower extremity atherosclerotic disease among the inpatients with type 2 diabetes mellitus(T2DM),in order to provide scientific basis for the clinical application in prevention of lower extremity atherosclerotic disease and further dysfunction in patients with T2 DM.Methods: A retrospective review was conducted in Metabolic Disease Hospital,Tianjin Medical University from January 1,2008 to March 1,2013 by means of extracting relevant information from medical records,organizing and establishing the database.A total of 2273 patients with T2 DM who had lower limb artery color doppler ultrasonic testing were included in this research.The prevalence of lower extremity atherosclerotic disease among the patients with T2 DM and its clinical features were analyzed.The related factors of lower extremity atherosclerotic disease among T2 DM patients were analyzed by non-conditional logistic regression and the odds ratio(OR)and 95% confidence interval(CI)were calculated.Results: 1.Among 2273 inpatients with T2 DM,a total of 1699 patients(74.7%)had lower limb artery lesions,in which,1373 patients(60.4%)had mild lesions,299 patients(13.2%)had moderate lesions and 27 patients(1.2%)had severe lesions.The prevalence of lower limb artery lesions increased with age and duration of diabetes,but had no significant difference between male and female T2 DM patients.2.Compared with patients who had no lower limb artery lesion,the T2 DM patients who had lower limb artery lesions were older,had longer duration of diabetes,and higher level of systolic blood pressure,blood urea nitrogen,serum creatinine,c-reactive protein and plasma fibrinogen and urine microalbumin,higher proportion of coronary heart disease,hypertension,cerebral infarction,peripheral neuropathy,diabetic retinopathy,diabetic nephropathy and diabetic foot,but lower level of body mass index,triglyceride,diastolic blood pressure and alcohol consumption.The difference in smoking rates among the three groups was statistically significant.3.The results of univariate logistic regression analysis showed that older,male,diabetic retinopathy,haemoglobin A1 c,and systolic blood pressure levels were associated with high risk of mild lower limb artery lesions among T2 DM patients;older,male,smoking,long duration of diabetes,diabetic retinopathy,diabetic foot,peripheral neuropathy,high fasting blood glucose levels,haemoglobin A1 c,systolic blood pressure levels,c-reactive protein,plasma fibrinogen and urinary microalbumin were associated with an increased risk of moderate or severe lower limb artery lesions among T2 DM patients.A common linear diagnosis was performed on the variables of single factor analysis.The results showed that variance inflation factor(VIF)was less than 5 and there was no collineness between the factors.The results of multivariate non-conditional logistic regression analysis showed that older,high systolic blood pressure and retinopathy were associated with higher risk of mild lower limb artery lesions,their OR(95% CI)were 2.432(2.046,2.046),1.008(1.001,1.001)and 1.001(1.191,1.191),respectively;older,high systolic blood pressure,long duration of diabetes,smoking,diabetic retinopathy and diabetic foot were associated with high risk of moderate or severe lower extremity artery lesions among T2 DM patients,their OR(95% CI)were 5.404(4.242,6.884),1.013(1.003,1.024),1.045(1.014,1.078),2.314(1.462,3.663),1.646(1.038,2.610),4.322(1.143,16.346)and 1.514(1.001,2.290),respectively.Conclusions: The overall prevalence of lower extremity artery disease was 74.7% among T2 DM patients.The prevalence increased with age and duration of diabetes.Older,higher systolic blood pressure level,longer duration of diabetes,smoking,diabetic retinopathy,diabetic foot,and peripheral neuropathy were associated with the risk of lower limb artery lesions among T2 DM patients.