The Study Of The Relationship Between Ankle-brachial Index And Microvascular Complications In Type 2 Diabetic Patients

Objective: To investigate the relationship between Ankle-brachial Index(ABI) and microvascular complications in type 2 diabetic patients and provide the basis for prevention of microvascular disease.Methods: 100 patients with type 2 diabetes were selected from the department of endocrinology of the Second Hospital of Jilin University since October 2009 to October 2010.All the patients were diagrosed according to WHO 1999 diagnostic criteria for diabetes;excluding those with acute complications of diabetes(such as diabetic ketosis,hyperosmolar coma,etc), acute and chronic infection,primary kidney disease, connective tissue disease, cancer.General state of health including gender,age,course of Diabetes,history of smoking and hypertension were recorded. All the patients were measured blood pressure (mmHg),height(m),weight(kg),and calculated body mass index(BMI).The levels of plasm total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol (HDL-C),fasting plasma glucose(FPG),creatinine(Cr),glycosylated hemoglo- binAlc (GHbAlc), 2-hour postprandial plasma glucose(2hPG) , microa- lbuminuria (MA) were tested. All the patients were given fundus fluorescein angiography and / or ophthalmoscopy by ophthalmologist.Ankle brachial indexes were measured by multi-purpose portable Doppler device(MD 2 type made by UK Huntleigh company).According to the ABI values, 100 patients with type 2 diabetes were divided into 2 groups:1) 1.0≤ABI≤1.3 was normal group.2)ABI<1.0 was abnormal group.All data are expressed as x±s,and t test were made when comparing the difference between two groups. Enumeration data were expressed as percentage(%).All statistical analysis were carried out in SPSS13.0 software package.Results: (1)Among all 100 type 2 diabetic patients,there were 83 cases in the normal group,accounting for 83%,which 41 cases were male and 42 cases were female; there were 17 cases in the abnormal group,accounting for 17%,which 6 cases were male and 11 cases were female. Gender composition of the two groups was not statistically significant by a chi-square test;For smoking,there were 19 cases in normal group,accounting for 22.9%;9 cases in abnormal group,accounting for 52.4%.Smoking rate in the abnormal group were significantly more than in the normal group(P<0.05).(2) Risk factors of diabetic microangiopathy such as age, duration of diabetes,GHbAlc,TC,LDL-C,systolic and diastolic blood pressure in the abnormal group were significantly different from the normal group.The abnormal group showed older,longer duration of diabetes,higher levels of TC,LDL-C, GHbAlc,higher systolic and diastolic blood pressure. (3) The normal group which 33 cases were DN and 17 cases were DR, accounting for 39.8%and 20.4%.The abnormal group which 13 cases were DN and 9 cases were DR, accounting for 76.5%and 52.9%.The prevalence of DN and DR in the abnormal group were significantly more than in the normal group(P<0.05).Conclusion: ABI can be used as an important means of forecasting microvascular complications of diabetes.The patients with declined ABI showed older,longer duration of diabetes,higher levels of TC,LDL-C, GHbAlc,higher systolic and diastolic blood pressure,higher of DN and DR.