Correlation between lower extremity arteriosclerosis obliterans and metabolic diseases

doi:10.3877/cma.j.issn.2095-9605.2025.02.005

Abstract

Abstract:

Objective

To explore the correlation between lower extremity atherosclerotic diseases (ASO) and metabolic diseases.

Methods

A single-center retrospective cohort study was launched at the Department of Vascular Surgery of Hainan General Hospital. In total, 626 consecutive patients with a first diagnosis of ASO and without a history of LEASO who received optimal clinical intervention from August 2013 to April 2023 were enrolled in our retrospective study. The data includes basic information and glycometabolism and lipid metabolism indicators, and is divided into groups according to the combination of different types of metabolic diseases.

Results

85.78% of patients with lower extremity ASO had at least one metabolic disease combined, and 43.29% had two or more metabolic diseases combined. After grouping by whether metabolic diseases were combined or not, the percentages of age (t=3.45), SBP (t=12.52), DBP (t=4.63) and combined diabetes (χ²=4.51), coronary heart disease (χ²=4.61) and cerebral infarction (χ²=12.99) were higher in the hypertensive group than the non-hypertensive group of patients with lower extremity ASO (all P<0.05), and the smoking rate was lower than that in the non-hypertensive group (χ²=5.89, P<0.05); in the diabetic group of lower extremity ASO patients, ABI (t=3.83), BMI (t=4.94), FBG (t=11.05), TG (t=3.19), femoral-popliteal percentage (χ²=4.71), and comorbidity with hypertension (χ²=4.51) and coronary heart disease (χ²=11.37), cerebral infarction (χ²=29.36) were higher than those in the non-diabetic group (all P<0.05), and age (t=-6.23), DBP (t=-2.42), SUA (t=-2.30), HCY (t=-3.33), TASC II C~D (χ²=5.28), and aorto-iliac percentage (χ²=4.71) and effective rate were lower than those in the non-diabetic group (all P<0.05); among lower extremity ASO patients in hyperlipoidemia group, the percentage of SUA (t=3.95), FBG (t=2.52), TC (t=19.79), TG (t=9.55), LDL (t=16.56) and combined diabetes mellitus (χ²=5.77) were higher than that of non-hyperlipoidemia group (all P<0.05) and age (t=-2.09), male (χ²=7.37), and smoking (χ²=11.06) were lower than in the non-hyperlipoidemia group.

Conclusions

All three metabolic diseases, hypertension, diabetes mellitus and hyperlipoidemia, are associated with the prevalence of lower extremity ASO patients, diabetes is likely to be an important factor leading to the youthfulness, complexity of pathology and poor prognosis of lower extremity ASO patients, and strengthening its screening and control is great significance for the prevention and control of lower extremity ASO.

Key words: Metabolic syndrome, Lower extremity arteriosclerosis obliterans, Tropical regions, Risk factors, Type 2 diabetes mellitus

Zhenzhen Li, Zhendong Liu, Hao Qian, Yuyang Xu, Youfei Qi, Zhanxiang Xiao, Min Liu. Correlation between lower extremity arteriosclerosis obliterans and metabolic diseases[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2025, 11(02): 111-120.

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Figures/Tables 9

References 48

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指标	高血压（447例）	非高血压（179例）	t/χ²值	β	SE	P	OR	OR的95%置信区间
指标	高血压（447例）	非高血压（179例）	t/χ²值	β	SE	P	OR	下限	上限
年龄（岁）	75.33±9.85	71.91±11.57	3.450	0.032	0.009	0.000	1.032	1.015	1.050
男/女[例（%）]	321（71.81%）/126（28.19%）	138（77.09%）/41（22.91%）	1.824	0.279	0.207	0.178	1.321	0.881	1.981
吸烟[例（%）]	187（41.83%）	94（52.51%）	5.893	-0.430	0.178	0.016	0.650	0.459	0.921
BMI（kg/m²）	20.91±3.06	20.41±3.04	1.035	-0.702	0.391	0.073	0.495	0.230	1.067
ABI	0.36±0.22	0.39±0.24	-1.653	0.014	0.009	0.111	1.015	0.997	1.033
SBP（mmHg）	151.80±22.26	129.70±18.74	12.523	0.051	0.005	0.000	1.053	1.042	1.064
DBP（mmHg）	77.56±13.80	72.77±10.60	4.629	0.032	0.008	0.000	1.033	1.017	1.049
SUA（μmol/L）	336.35±106.80	316.85±102.02	2.073	0.002	0.001	0.052	1.002	1.000	1.003
FPG（mmol/L）	5.74±2.27	5.95±3.53	-0.761	-0.036	0.031	0.254	0.965	0.907	1.026
TC（mmol/L）	4.57±1.26	4.48±1.02	0.904	0.058	0.075	0.445	1.059	0.914	1.228
TG（mmol/L）	1.37±1.00	1.39±1.23	-0.239	-0.015	0.082	0.853	0.985	0.839	1.156
LDL（mmol/L）	2.61±1.00	2.54±0.78	1.045	0.081	0.095	0.397	1.084	0.899	1.307
HCY（μmol/L）	17.11±9.28	16.60±16.89	0.482	0.005	0.009	0.575	1.005	0.988	1.022
主髂/股腘[例（%）]	106（23.71%）/341（76.29%）	47（26.26%）/132（73.74%）	0.448	0.136	0.203	0.504	1.145	0.769	1.705
Rutherford（分级1~3/4~6级）[例（%）]	45（10.07%）/402（89.93%）	18（10.06%）/161（89.94%）	0	-0.001	0.294	0.997	0.999	0.561	1.777
TASCⅡ（A~B /C~D型）[例（%）]	128（28.64%）/319（71.36%）	56（31.28%）/123（68.72%）	0.432	0.126	0.192	0.511	1.135	0.779	1.654
糖尿病[例（%）]	154（34.45%）	46（25.70%）	4.505	0.418	0.198	0.034	1.520	1.031	2.240
高脂血症[例（%）]	168（37.58%）	61（34.08%）	0.539	0.238	0.187	0.204	1.268	0.879	1.830
冠心病[例（%）]	116（25.95%）	32（17.88%）	4.615	0.476	0.223	0.033	1.610	1.040	2.492
脑梗塞[例（%）]	50（11.19%）	4（2.23%）	12.992	1.707	0.527	0.001	5.510	1.960	15.493
有效率[例（%）]	332（74.27%）	135（75.42%）	0.038	0.168	0.201	0.402	1.183	0.798	1.754

指标	高血压（447例）	非高血压（179例）	t/χ²值	β	SE	P	OR	OR的95%置信区间
指标	高血压（447例）	非高血压（179例）	t/χ²值	β	SE	P	OR	下限	上限
年龄（岁）	75.33±9.85	71.91±11.57	3.450	0.032	0.009	0.000	1.032	1.015	1.050
男/女[例（%）]	321（71.81%）/126（28.19%）	138（77.09%）/41（22.91%）	1.824	0.279	0.207	0.178	1.321	0.881	1.981
吸烟[例（%）]	187（41.83%）	94（52.51%）	5.893	-0.430	0.178	0.016	0.650	0.459	0.921
BMI（kg/m²）	20.91±3.06	20.41±3.04	1.035	-0.702	0.391	0.073	0.495	0.230	1.067
ABI	0.36±0.22	0.39±0.24	-1.653	0.014	0.009	0.111	1.015	0.997	1.033
SBP（mmHg）	151.80±22.26	129.70±18.74	12.523	0.051	0.005	0.000	1.053	1.042	1.064
DBP（mmHg）	77.56±13.80	72.77±10.60	4.629	0.032	0.008	0.000	1.033	1.017	1.049
SUA（μmol/L）	336.35±106.80	316.85±102.02	2.073	0.002	0.001	0.052	1.002	1.000	1.003
FPG（mmol/L）	5.74±2.27	5.95±3.53	-0.761	-0.036	0.031	0.254	0.965	0.907	1.026
TC（mmol/L）	4.57±1.26	4.48±1.02	0.904	0.058	0.075	0.445	1.059	0.914	1.228
TG（mmol/L）	1.37±1.00	1.39±1.23	-0.239	-0.015	0.082	0.853	0.985	0.839	1.156
LDL（mmol/L）	2.61±1.00	2.54±0.78	1.045	0.081	0.095	0.397	1.084	0.899	1.307
HCY（μmol/L）	17.11±9.28	16.60±16.89	0.482	0.005	0.009	0.575	1.005	0.988	1.022
主髂/股腘[例（%）]	106（23.71%）/341（76.29%）	47（26.26%）/132（73.74%）	0.448	0.136	0.203	0.504	1.145	0.769	1.705
Rutherford（分级1~3/4~6级）[例（%）]	45（10.07%）/402（89.93%）	18（10.06%）/161（89.94%）	0	-0.001	0.294	0.997	0.999	0.561	1.777
TASCⅡ（A~B /C~D型）[例（%）]	128（28.64%）/319（71.36%）	56（31.28%）/123（68.72%）	0.432	0.126	0.192	0.511	1.135	0.779	1.654
糖尿病[例（%）]	154（34.45%）	46（25.70%）	4.505	0.418	0.198	0.034	1.520	1.031	2.240
高脂血症[例（%）]	168（37.58%）	61（34.08%）	0.539	0.238	0.187	0.204	1.268	0.879	1.830
冠心病[例（%）]	116（25.95%）	32（17.88%）	4.615	0.476	0.223	0.033	1.610	1.040	2.492
脑梗塞[例（%）]	50（11.19%）	4（2.23%）	12.992	1.707	0.527	0.001	5.510	1.960	15.493
有效率[例（%）]	332（74.27%）	135（75.42%）	0.038	0.168	0.201	0.402	1.183	0.798	1.754

		β	SE	P	OR	OR的95%置信区间
		β	SE	P	OR	下限	上限
步骤1^a	年龄	0.026	0.011	0.015	1.026	1.005	1.048
	吸烟	-0.085	0.210	0.687	0.919	0.609	1.387
	SBP	0.050	0.006	0.000	1.051	1.039	1.064
	DBP	-0.002	0.010	0.840	0.998	0.978	1.018
	糖尿病	0.335	0.242	0.166	1.398	0.870	2.247
	冠心病	0.256	0.260	0.324	1.292	0.776	2.151
	脑梗死	1.468	0.568	0.010	4.340	1.426	13.205
	常量	-8.060	1.220	0.000	0.000

		β	SE	P	OR	OR的95%置信区间
		β	SE	P	OR	下限	上限
步骤1^a	年龄	0.026	0.011	0.015	1.026	1.005	1.048
	吸烟	-0.085	0.210	0.687	0.919	0.609	1.387
	SBP	0.050	0.006	0.000	1.051	1.039	1.064
	DBP	-0.002	0.010	0.840	0.998	0.978	1.018
	糖尿病	0.335	0.242	0.166	1.398	0.870	2.247
	冠心病	0.256	0.260	0.324	1.292	0.776	2.151
	脑梗死	1.468	0.568	0.010	4.340	1.426	13.205
	常量	-8.060	1.220	0.000	0.000

指标	糖尿病（200例）	非糖尿病（426例）	t/χ²值	β	SE	P	OR	OR的95%置信区间
指标	糖尿病（200例）	非糖尿病（426例）	t/χ²值	β	SE	P	OR	下限	上限
年龄（岁）	70.64±10.33	76.07±10.09	-6.230	-0.051	0.009	0.000	0.950	0.934	0.966
男/女[例（%）]	146（73%）/54（27%）	313（73.47%）/113（26.53%）	0.016	0.024	0.193	0.900	1.024	0.701	1.497
吸烟[例（%）]	83（41.5%）/117（58.5%）	198（46.48%）/228（53.52%）	1.364	-0.202	0.173	0.243	0.817	0.582	1.147
BMI（kg/m²）	22.06±2.58	20.11±3.08	4.942	0.016	0.008	0.061	1.016	0.999	1.033
ABI	0.42±0.23	0.35±0.22	3.835	1.452	0.387	0.000	4.272	2.000	9.124
SBP（mmHg）	147.3±22.90	144.59±23.88	1.342	0.005	0.004	0.180	1.005	0.998	1.012
DBP（mmHg）	74.34±12.40	77.05±13.38	-2.422	-0.017	0.007	0.016	0.983	0.969	0.997
SUA（μmol/L）	317.03±108.54	337.76±103.78	-2.297	-0.002	0.001	0.023	0.998	0.996	1.000
FBG（mmol/L）	7.87±3.81	4.85±0.96	11.045	0.868	0.084	0.000	2.382	2.019	2.810
TC（mmol/L）	4.55±1.26	4.54±1.17	0.059	0.004	0.072	0.955	1.004	0.872	1.156
TG（mmol/L）	1.60±1.38	1.26±0.86	3.189	0.314	0.096	0.001	1.370	1.134	1.654
LDL（mmol/L）	2.62±1.01	2.58±0.92	0.377	0.034	0.090	0.706	1.035	0.867	1.235
HCY（μmol/L）	14.65±6.80	18.01±13.50	-3.331	-0.057	0.015	0.000	0.944	0.917	0.973
主髂/股腘[例（%）]	38（19%）/162（81%）	115（27%）/311（73%）	4.711	0.455	0.211	0.031	1.576	1.043	2.382
Rutherford（分级1~3/4~6级）[例（%）]	24（12%）/176（88%）	39（9.15%）/387（90.85%）	1.217	-0.302	0.275	0.271	0.739	0.431	1.267
TASCⅡ（A~B /C~D）[例（%）]	71（35.5%）/129（64.5%）	113（26.53%）/313（73.47%）	5.282	-0.422	0.184	0.022	0.656	0.457	0.941
高血压[例（%）]	154（77%）	293（68.78%）	4.505	0.418	0.198	0.034	1.520	1.031	2.240
高脂血症[例（%）]	86（43%）	142（33.33%）	5.083	0.422	0.176	0.017	1.525	1.080	2.153
冠心病[例（%）]	64（32%）	84（19.72%）	11.372	0.650	0.194	0.001	1.916	1.309	2.805
脑梗塞[例（%）]	35（17.5%）	19（4.46%）	29.361	1.514	0.300	0.000	4.544	2.526	8.173
有效率[例（%）]	156（78%）	311（73%）	1.538	0.458	0.209	0.028	1.582	1.051	2.381

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