Individuals with Peripheral Artery Disease (PAD) and Type 1 Diabetes Are More Likely to Undergo Limb Amputation than Those with PAD and Type 2 Diabetes.
Individuals with Peripheral Artery Disease (PAD) and Type 1 Diabetes Are More Likely to Undergo Limb Amputation than Those with PAD and Type 2 Diabetes.
复制标题
DOI：
10.3390/jcm9092809
复制
发表时间：
2020-08-31
影响因子：
3.9
通讯作者：
Dokun AO
中科院分区：
文献类型：
--
作者：
Jain N;Agarwal MA;Jalal D;Dokun AO
背景资料：比较1型糖尿病（DM）和2型糖尿病对外周动脉疾病（PAD）严重程度的不同影响的数据有限。我们的目的是研究糖尿病的类型与诊断为PAD的住院手术的相关性。研究方法：我们使用了2003年至2014年的全国住院患者样本数据库，以确定诊断为PAD和1型或2型DM的住院患者。采用逻辑回归评价DM类型与所用手术（截肢-总体、大面积、血管内血运重建、外科血运重建）之间的相关性。结果：我们确定了14，012，860例PAD诊断和DM住院，5.6%（n = 784，720）为1型DM。与2型DM患者相比，1型DM患者更可能出现慢性肢体威胁性缺血（CLTI）（45.2% vs. 32.0%）、溃疡（25.9% vs. 17.7%）或并发性溃疡（16.6% vs. 10.5%）（均p < 0.001）。1型糖尿病与更多截肢手术独立且显著相关（校正比值比= 1.12，95%置信区间[CI] I 1.08至1.16，p < 0.001）。总的来说，1型和2型糖尿病患者的住院死亡率没有差异。总体平均（95% CI）住院时间（天）为6.6（6.5 - 6.6），与2型DM患者（6.5 [6.4 - 6.6]）相比，1型DM患者（7.8 [7.7 - 8.0]）显著更长。结论：我们观察到，与PAD和2型糖尿病患者相比，PAD和1型糖尿病患者更容易出现CLTI和溃疡，并接受截肢。需要进一步的研究来更好地理解这些发现背后的潜在机制，并确定新的干预措施来降低1型糖尿病患者截肢的风险。
Background: Limited data exist comparing how type 1 diabetes mellitus (DM) and type 2 DM may have differential effects on peripheral artery disease (PAD) severity. We aimed to study the association of type of DM with the procedure utilized in hospitalizations with a diagnosis of PAD. Methods: We used the national inpatient sample databases from 2003 to 2014 to identify hospitalizations with a diagnosis of PAD and type 1 or type 2 DM. Logistic regression was utilized to evaluate the association between type of DM and procedure utilized (amputation-overall, major, endovascular revascularization, surgical revascularization). Results: We identified 14,012,860 hospitalizations with PAD diagnosis and DM, 5.6% (n = 784,720) had type 1 DM. The patients with type 1 DM were more likely to present with chronic limb-threatening ischemia (CLTI) (45.2% vs. 32.0%), ulcer (25.9% vs. 17.7%), or complicated ulcer (16.6% vs. 10.5%) (all p < 0.001) when compared to those with type 2 DM. Type 1 DM was independently and significantly associated with more amputation procedures (adjusted odds ratio = 1.12, 95% confidence interval [CI] I 1.08 to 1.16, p < 0.001). Overall, in-hospital mortality did not differ between the individuals with type 1 and type 2 DM. The overall mean (95% CI) length of stay (in days) was 6.6 (6.5 to 6.6) and was significantly higher for type 1 DM (7.8 [7.7 to 8.0]) when compared to those with type 2 DM (6.5 [6.4 to 6.6]). Conclusion: We observed that individuals with PAD and type 1 DM were more likely to present with CLTI and ulcer and undergo amputation when compared to those with PAD and type 2 diabetes. Further studies are needed to better understand the underlying mechanisms behind these findings and to identify novel interventions to reduce the risk of amputation in patients with type 1 DM.
登录
查看更多内容
影响因子：
168.9
作者：
Fowkes, F. Gerald R.;Rudan, Diana;Criqui, Michael H.
通讯作者：
Criqui, Michael H.
DOI：
10.1016/j.mayocpiqo.2017.05.004
发表时间：
2017-07-01
期刊：
Mayo Clinic proceedings. Innovations, quality & outcomes
影响因子：
--
作者：
Agarwal, Manyoo;Agrawal, Sahil;Lavie, Carl J
通讯作者：
Lavie, Carl J
影响因子：
13.2
作者：
Garimella, Pranav S.;Hart, Peter D.;Hirsch, Alan T.
通讯作者：
Hirsch, Alan T.
影响因子：
2.8
作者：
Agarwal, Manyoo;Agrawal, Sahil;Lavie, Carl J.
通讯作者：
Lavie, Carl J.
影响因子：
4.3
作者：
Lo, Ruby C.;Bensley, Rodney P.;Schermerhorn, Marc L.
通讯作者：
Schermerhorn, Marc L.