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Objective To study the assosiation of angiopoietin-like protein 2 (ANGPTL2) to lower extremity arterial disease in type 2 diabetes mellitus.Methods A total of 360 type 2 diabetic patients were divided into three groups:without (group A),with mild to moderate (group B),and severe (group C) lower extremity arterial disease according to the ankle brachial index.And,120 healthy subjects serveed as control group.The levels of ANGPTL2,high sensitivity C-reactive protein (hsCRP),free fatty acid,biochemical index,and fasting insulin were detected.And,waist-to-hip ratio (WHR),body mass index (BMI),insulin resistance index were calculated.Results The level of ANGPTL2 was getting higher and higher as lower extremity arterial disease progressing.The level of ANGPTL2 in group B was higher than that in group A [1.27 (1.09,1.51) vs 0.88 (0.66,1.07) μg/L,P＜0.05],and the level of ANGPTL2 in group C was higher than that in group B [1.70 (1.45,1.91) vs 1.27 (1.09,1.51)μg/L,P＜0.05].Pearson correlation analysis showed that the ANGPTL2 level in serum positively correlated with hsCRP,BMI,WHR,cholesterol,low-density lipoprotein-cholesterol,fasting insulin,and insulin resistance index.Logistic regression analysis showed that the levels of ANGPTL2,hsCRP,and glycosylated hemoglobin were significantly associated with lower extremity arterial disease in type 2 diabetes mellitus.Conclusion It is possible that ANGPTL2 is one of the risk factors of lower extremity arterial disease in type 2 diabetes mellitus,and which is likely to be of great significance in the early prediction,disease assessment,and prognosis evaluation for lower extremity arterial disease in type 2 diabetes mellitus.
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Objective To investigate the clinical application and its influencing factors of ankle-brachial index (ABI) and toe-brachial index (TBI) in the diagnosis of arterial disease of lower extremity. Methods ABI and TBI were measured in 800 limbs of 402 patients with diabetes and/or hypertension hospitalized from July 2010 to February 2011. The patients were divided into narrow group (ABI<0.9), normal group (0.9≤ABI<1.3), and calcification group (ABI≥1.3) according to the value of ABI, and also into narrow group (TBI<0.7) and normal group (TBI≥0.7) according to the value of TBI. The correlation of ABI with TBI was analyzed, and the differences in age, obesity parameters, biochemical indicators and other factors were compared between the groups. Influence of high-sensitivity C-reactive protein (hs-CRP) on ABI and TBI was further analyzed. Results Only when ABI<0.9, ABI and TBI have significant correlation (r=0.826, P<0.01). When the group comparison based on ABI values, it was shown that the age and hs-CRP were significantly higher in the narrow group than in the normal group and calcification group (P<0.01). The comparison between groups based on TBI values indicated that the age, systolic blood pressure and hs-CRP in the narrow group were significantly higher than those in the normal group (P<0.01 or P<0.05). ABI and TBI in the normal hs-CRP group were significantly higher than those in high hs-CRP group (P<0.05). Conclusion Hs-CRP may play an important role in the development and progression in peripheral arterial atherosclerosis. Therefore, ABI and TBI measurements in combination with hs-CRP level can improve early diagnosis of arterial disease of lower extremity.
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Objective To evaluate the clinical value of 16-slice spiral CTA for the diagnosis of lower extremity arterial disease.Methods A total of 103 patients with arterial disease at the lower extremities were submitted to 16-slice spiral CTA.A scanner with a slice thickness of 5 mm,pitch 1.15 mm,increment 1.0 mm,and overlapping 30% was used.Totally 90-100 ml of contrast agent was injected at a rate of 3 ml/s.The scanning was started with a Smartprep auto-trigger and persisted for 20-30 s.The reconstructed images were reformed by means of maximum intensity projection,volume rendering technique,and multiplanar reformation.Results The reconstructed images of the 103 cases were clearly demonstrated by CTA,which showed arteriosclerotic occlusion in 64 patients,arteriostenosis in 32,aneurysm in 4,and normal vessels in 3.Among the 103 patients,40 received surgical treatment,which confirmed the results of CTA.Conclusion Lesions in the lower extremity arteries can be well demonstrated by 16-slice spiral CTA,which can serve as a pre-surgery screening and evaluation.