Comparison Of Ankle-brachial Index And Its Impact Factors Between Urban And Rural Population

Objective: The clinical value of ankle-brachial index (ABI) in diagnosing peripheral atherosclerotic disease and predicting cardiovascular and cerebrovascular diseases, has been widely recognized in abroad, but in domestic is not used frequently. The purpose of this study was to investigate the ABI level of urban and rural population, and to analyze the possible impact factors, to investigate the differences of ABI impact factors between urban and rural areas, so as to achieve clinical evidence to prevent peripheral atherosclerosis disease and cardiovascular diseases and cerebrovascular diseases in urban and rural population.Methods: During March 2008 to November 2008, using cluster sampling method, we selected 1302 permanent resident from four communities in Chaoyang District of Beijing, and selected 1032 fixed residents from five villages in Tang jiakou Town Huairou District of Beijing. we collected general information from all population, including: gender, age, height, weight, waist, blood pressure, history of hypertension (HBP) , history of diabetes mellitus (DM), history of stroke and coronary heart disease (CHD), as well as history of smoking and drinking. Then measured: fasting blood glucose (Glu), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipid protein cholesterol (HDL-C). In addition, a portable Doppler flow imaging equipment was used to measure the ABI level. After collecting all of above information, epidate database was established. Statistical software spss 13.0 was used to analyze the data. T test, analysis of covariance,χ2 test and multivariate linear stepwise regression analysis were used in this study.Results: (1) LDL-C level of rural population was significantly higher than that of urban population (2.85±0.79mmol / L vs 2.52±0.68mmol / L; P=0.000). The percentage of LDL-C abnormal (>3.12mmol / L) was higher in rural population group than that in urban group (33.53% vs 17.43%;P=0.000;χ2=79.62). The level of glucose in rural population group was significantly higher than that in urban population group (5.29±1.66mmol / L vs 4.81±1.71mmol / L,P=0.000). There was no significantly difference between rural group and urban group (11.14% vs 9.83%;P=0.335;χ2 = 0.927) in the percentage of glucose abnormal (≥6.1mmol / L). Between the two groups, there were no significantly difference in systolic blood pressure, diastolic blood pressure and pulse pressure (124.84±18.72mmHg vs 127.63±20.97mmHg,79.97±10.41mmHg vs 82.04±11.25mmHg,44.87±14.72mmHg vs 45.54±14.54mmHg;P=0.237,0.554,0.372), but the percentage of systolic blood pressure abnormal (≥140mmHg), diastolic blood pressure abnormal (≥90mmHg), and one of them abnormal were higher in rural group than that in urban group (31.69% vs 22.43%,32.66% vs 24.58%,40.02% vs 32.57%;p=0.000;χ2=24.85,18.17,13.58). (2) The ABI level of rural population group was significantly lower than that of urban population group (1.05±0.12 vs 1.14±0.12;P= 0.000). In rural population group, there were 81 cases whose ABI was≤0.9. In urban population group, there were 31 cases whose ABI was≤0.9. Rural population was significantly more than urban population (7.85% vs 2.38%;P=0.000;χ2 =36.48). In urban population group, ABI level of women was significantly lower than men (1.123±0.116 vs 1.164±0.125;P=0.000). The ABI level in the history of coronary heart disease population group was lower than that in no history of coronary heart disease population group (1.103±0.138 vs 1.141±0.116;P=0.026). The ABI level in the history of stroke population group was lower than that in no history of stroke population group (1.065±0.157 vs 1.141±0.118;P=0.000). In rural population group, ABI level of women was significantly lower than men (1.031±0.103 vs 1.071±0.130;P=0.004). The ABI level in the history of hypertension population group was lower than that in no history of hypertension population group (1.028±0.120 vs 1.051±0.114;P=0.014). (3) Taken urban and rural population as a whole, the ABI level as dependent variable, and the impact factors as the independent variables. Multiple linear stepwise regression analysis was made. The following variables were included in the regression equation: region (X1), sex (X2), BMI (X3), history of diabetes (X4), pulse pressure (X5), HDL-C (X6), age (X7), LDL-C (X8). Regression equation was writen as follow: Y= 0.949 + 0.089X1 + 0.045X2 + 0.005X3 - 0.038X4 - 0.001X5 + 0.028X6 -0.001X7 -0.007X8. Taken urban population as a whole, the following variables were included in the regression equation: gender (X1), BMI (X2), pulse pressure (X3), history of diabetes (X4), glucose (X5), history of smoking (X6). Regression equation was writen as follow: Y= 1.070 + 0.056X1 + 0.006X2 - 0.001X3 - 0.040X4 - 0.006X5 - 0.025X6. Taken rural population as a whole, the following variables were included in the regression equation: gender (X1), BMI (X2), LDL-C(X3), HDL -C (X4), waist (X5), age (X6), history of hypertension (X7). Regression equation was writen as follow: Y= 0.885 + 0.042X1 + 0.004X2 - 0.015X3 +0.032X4 +0.001X5 -0.001 X6 -0.021X7.Conclusions: There were differences of ABI level between urban and rural population. The ABI level of rural population is lower than that of urban population. The impact factors of ABI level in urban population were different with rural population. In urban population, the ABI level was associated with gender, BMI, pulse pressure, history of diabetes, glucose, history of smoking; In rural population, gender, BMI, LDL-C, HDL-C, waist, age, history of hypertension were associated with ABI level.