Stiffness and impaired blood flow in lower-leg arteries are associated with severity of coronary artery calcification among asymptomatic type 2 diabetic patients.
Stiffness and impaired blood flow in lower-leg arteries are associated with severity of coronary artery calcification among asymptomatic type 2 diabetic patients.
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DOI：
10.2337/diacare.27.10.2409
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发表时间：
2004-10
期刊：
影响因子：
16.2
通讯作者：
M. Tsuchiya;E. Suzuki;K. Egawa;Y. Nishio;H. Maegawa;S. Inoue;K. Mitsunami;S. Morikawa;T. Inubushi;A. Kashiwagi
中科院分区：
文献类型：
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作者：
M. Tsuchiya;E. Suzuki;K. Egawa;Y. Nishio;H. Maegawa;S. Inoue;K. Mitsunami;S. Morikawa;T. Inubushi;A. Kashiwagi
目的探讨无症状糖尿病患者下肢动脉僵硬和血流受损与冠状动脉钙化程度的关系。研究设计和方法我们纳入了102例无心血管并发症病史的无症状2型糖尿病患者。使用电子束计算机断层扫描获得Agatston冠状动脉钙化（CAC）评分，作为冠状动脉钙化的标志。使用门控二维电影模式相位对比磁共振成像评价腘动脉的总流量和阻力指数（作为血管阻力的指标）。肱踝脉搏波速度（PWV），作为下肢动脉扩张性的指标，也使用自动装置测量。结果当患者按照CAC评分0-10（n = 54）、11-100（n = 25）和> 100（n = 23）分组时，评分最高的患者被认为是可能的冠状动脉疾病，结果显示，各组间的臂踝PWV和阻力指数最高（P <0.001），总流量最低（P < 0.001）。直线回归分析显示，肱踝PWV（r = 0.508，P < 0.001）和阻力指数（r = 0.500，P < 0.001）与CAC评分呈显著正相关，总流量（r =-0.528，P < 0.001）与CAC评分呈显著负相关。接受者操作特征曲线分析表明，臂踝PWV为1，800 cm/s、阻力指数为1.03、总流量为70 ml/min是识别评分最高患者的诊断值。结论：定量评估下肢动脉僵硬度和血流受损可能有助于识别糖尿病患者可能患有冠状动脉疾病。
OBJECTIVE To clarify whether stiffness and impaired blood flow in lower-leg arteries are associated with severity of coronary artery calcification among asymptomatic diabetic patients. RESEARCH DESIGN AND METHODS We enrolled 102 asymptomatic type 2 diabetic patients with no history of cardiovascular complications consecutively admitted to our hospital. Agatston coronary artery calcium (CAC) score, as a marker of coronary artery calcification, was obtained using electron-beam computed tomography. Total flow volume and resistive index, as an index of vascular resistance, at the popliteal artery were evaluated using gated two-dimensional cine-mode phase-contrast magnetic resonance imaging. Brachial-ankle pulse-wave velocity (PWV), as an index of distensibility in the lower-extremity arteries, was also measured using an automatic device. RESULTS When the patients were grouped according to CAC scores of 0-10 (n = 54), 11-100 (n = 25), and > 100 (n = 23), those with the highest scores, which is considered to show possible coronary artery disease, showed the highest brachial-ankle PWV (P < 0.001) and resistive index (P < 0.001) and the lowest total flow volume (P < 0.001) among the groups. Simple linear regression analyses showed that both brachial-ankle PWV (r = 0.508, P < 0.001) and resistive index (r = 0.500, P < 0.001) were positively correlated and total flow volume (r = -0.528, P < 0.001) was negatively correlated with the log-transformed CAC score. Receiver operator characteristic curve analyses indicated that 1,800 cm/s for brachial-ankle PWV, 1.03 for resistive index, and 70 ml/min for total flow volume were diagnostic values for identifying patients with the highest scores. CONCLUSIONS Quantitatively assessed stiffness and impaired blood flow in lower-leg arteries may help identify diabetic patients with possible coronary artery disease.