죽상경화증의 고위험 인자를 내재한 제2형 당뇨병 환자에서 말초동맥질환의 유병률 및 임상적 특징에 대한 다기관 공동연구 = Multi-country Study on the Prevalence and Clinical Features of Peripheral Arterial Disease in Type 2 Diabetic Patients Who are at High Risk for Atherosclerosis

다국어 초록 (Multilingual Abstract)

Background: PAD-SEARCH (Peripheral Arterial Disease - Screening and Evaluation of diabetic patients in Asian Regions Characterized by High risk factors) is the first international study to investigate the prevalence of peripheral arterial disease (PAD) in Asian type 2 diabetic patients and to demonstrate the relationships between the putative risk factors and PAD in this population.Methods: A total of 6,625 type 2 diabetic patients (2,873 males and 3,752 females aged 50 and older) were enrolled in PAD-SEARCH in Korea, China, Taiwan, Hong Kong, Indonesia, Thailand and Philippines from 攀접수일자: 2005년 6월 3일통과일자: 2006년 4월 10일

국문 초록 (Abstract)

연구배경: PAD-SEARCH 연구는 죽상경화증의 고위험 인자를 내재한 아시아 지역의 제2형 당뇨병 환자에서 말초동맥질환(peripheral arterial disease, PAD)의 유병률과 임상적 특징을 파악하기 위해 시행된 대단위 연구이다.대상 환자 및 방법: 2003년 10월부터 2004년 3월까지 고혈압, 흡연, 이상지질혈증 등의 위험인자를 가지는 50세 이상의 제2형 당뇨병 환자 6,625명을 대상으로 한국, 중국, 대만, 홍콩, 인도네시아, 태국, 필리핀 등 아시아의 7개 연구지역에서 본 연구가 시행되었다. Fukuda vascular profile VS-1000을 사용하여 대상 환자들의 ankle-brachial index (ABI)와 brachial-ankle pulse wave velocity (baPWV)를 측정하여 PAD를 진단하였고 환자들의 특성에 따라 세분하여 임상적 특징을 살펴보았다. 결과: 환자들의 평균 연령은 63.7 ± 8.2세로 이들의 평균 당뇨병 유병기간은 10.3 ± 8.0년이었으며 전체 환자의 17.7%인 1,172명의 환자에서 ABI 0.9 이하인 PAD로 진단되었다. PAD 환자들은 당뇨병 및 고혈압의 유병기간이 유의하게 길고 당화혈색소가 높았으며 체질량지수가 유의하게 낮았다. 지질관련 항목에서는 중성지방만이 PAD 유무에 따른 유의한 차이를 보여주었다. 성별에 따라 비교했을 때 ABI가 정상인 환자에서는 여자의 평균 ABI와 baPWV는 남자보다 유의하게 낮았다. 하지만 PAD 환자군에서 남자의 평균 ABI와 baPWV가 여자보다 유의하게 낮아서 성별에 따른 유의한 차이를 보였다. 다변량분석 결과 성별, 연령, 체질량지수, 흡연, 이전 대혈관 합병증의 과거력, 당뇨병의 유병기간 등은 PAD에 대한 독립적인 위험인자였다.

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