Relationship between cerebrovascular disease and peripheral vascular disease in patients with type 2 diabetes mellitus / 中国基层医药

ABSTRACT

Objective:To compare the incidence of carotid artery and lower extremity arterial disease between patients with type 2 diabetes mellitus complicated by cerebrovascular disease and those with no cerebrovascular disease and investigate the risk relationship between diabetic peripheral vascular disease and cerebrovascular disease.Methods:A total of 133 patients with type 2 diabetes mellitus complicated by cerebrovascular disease who received treatment in the Department of Endocrinology, The First People's Hospital of Kunming, China between June 2015 and June 2016 were included in the observation group. Sixty-six type 2 diabetes mellitus patients with no cerebrovascular disease were included in the control group. The incidence and severity of carotid artery and lower extremity arterial disease were compared between the observation and control groups. Stepwise logistic regression was performed taking whether cerebrovascular disease exists as a dependent variable. The risk factors for developing cerebrovascular disease in patients with type 2 diabetes mellitus were investigated.Results:The number of patients who had carotid plague in the observation group was significantly higher than that in the control group [66.17% (88/133) vs. 42.42% (28/66)]. Cervical vascular disease in the observation group was severer than that in the control group. In the observation group, 24.81% (33/133) of patients had rough carotid intima, and 9.02% (12/133) of patients had no rough carotid intima. In the control group, 33.33% (22/66) of patients had rough carotid intima, and 24.24% (16/66) of patients had no rough carotid intima. There was significant difference in the incidence of rough carotid intima between observation and control groups ( χ2 = 14.140, P = 0.030). The proportion of patients who had lower extremity carotid plaque in the observation group was higher than that in the control group [72.93% (97/133) vs. 42.42% (28/66)]. Lower extremity arterial disease in the observation group was severer than that in the control group. In the observation group, 22.56% (30/133) of patients had rough intima of lower extremity arteries and 4.51% (6/133) of patients had no rough intima of lower extremity arteries. In the control group, 33.33% (22/66) of patients had rough intima of lower extremity arteries and 24.24% (16/66) of patients had no rough intima of lower extremity arteries. There was significant difference in the proportion of rough intima of lower extremity arteries between observation and control groups ( χ2 = 24.030, P < 0.001). Logistic regression analysis showed that age, glycosylated hemoglobin, and the presence of lower extremity vascular disease were the risk factors for cerebrovascular disease [95% CI = 1.098 (1.051 -1.146), 1.240 (1.015-1.515), 3.802 (1.094-13.212)]. Conclusion:Peripheral vascular disease in patients with type 2 diabetes mellitus complicated by cerebrovascular disease is severer than that in patients with type 2 diabetes mellitus but without cerebrovascular disease. Aging, poor blood glucose control and lower extremity vascular disease are the risk factors for developing cerebrovascular disease in patients with type 2 diabetes mellitus. Lower extremity vascular disease has a certain value for predicting the occurrence of cerebrovascular disease in patients with type 2 diabetes mellitus.