Abstract
The motive of this article is to present the case study of patients to investigate the association between the ultrasonographic findings of lower extremity vascular disease (LEAD) and plaque formation. Secondly, to examine the association between the formation of coronary artery and carotid artery atherosclerosis in patients with type 2 diabetes mellitus. 124 patients with type 2 diabetes (64 males and 60 females with the age group 25-78 years) are considered for the research studies who have registered themselves in the Department of Endocrinology and Metabolism from April 2017 to February 2019. All participants have reported their clinical information regarding diabetes, alcohol consumption, smoking status, and medication. The blood samples from subjects are collected for measurement of HbA1c, total cholesterol, triglycerides, HDL-c, and LDL-c levels. Two-dimensional ultrasound has been used to measure the inner diameter, peak flow velocity, blood flow, and spectral width of the femoral artery, pop artery, anterior iliac artery, posterior tibial artery, and dorsal artery and to calculate the artery stenosis degree. Independent factors of atherosclerosis are determined by multivariate logistic regression analysis. The results are evaluated within the control group and it is found that there is no significant impact of gender, age, and body mass index (P > 0.05) on the lower extremity vascular diseases. Those with smoking, alcohol consumption, hypertension, and dyslipidemia have higher positive rate (P < 0.05). The type 2 diabetes mellitus group has higher diastolic blood pressure and lower triglyceride (P < 0.05). Diastolic blood pressure, HbA1C, total cholesterol, HDL-c, and LDL-C are not remarkably dissimilar between the type 2 diabetes mellitus group and the control group (P > 0.05). Compared with the control group, the type 2 diabetes mellitus group has higher frequency of lower extremity vascular diseases in the dorsal artery than in the pop artery (P < 0.05). The blood flow of type 2 diabetes mellitus group is found to be lower than that of the control group, especially in the dorsal artery (P < 0.05). The blood flow velocity of the dorsal artery is accelerated (P < 0.01). Among 117 patients of type 2 diabetes mellitus (94.35%) with a certain degree of injury, there are 72 cases of type I carotid stenosis (58.06%), 30 cases of type II carotid stenosis (24.19%), and 15 cases of type III carotid stenosis (12.10%). Out of 108 subjects in the control group, there are 84 cases of type 0 carotid stenosis (77.78%), 19 cases of type I carotid stenosis (17.59%), 5 cases of type II carotid stenosis (4.63%), and 0 case of type III carotid stenosis (0.00%). Compared with the control group, carotid stenosis is more common in patients with type 2 diabetes mellitus (P < 0.05). Age, smoking, duration of diseases, systolic blood pressure, and degree of carotid stenosis are found to be associated with atherosclerosis. The findings suggest that the color Doppler ultrasonography can give early warning when applied in patients with carotid and lower extremity vascular diseases to delay the incidence of diabetic macroangiopathy and to control the development of cerebral infarction, thus providing an important basis for clinical diagnosis and treatment.
Highlights
Lower extremity vascular disease (LEAD) is the main manifestation of peripheral artery disease
Patients with diabetes mellitus usually are unaware of the fact that the early progress of lower extremity vascular disease is due to the loss of pain and the decreasing frequency of intermittent claudication, until the symptoms get worsen and the disease turns into an ulcer or gangrene, which usually occurs at the last stage of the lower extremity vascular disease and eventually leads to amputation [4, 5]
Atherosclerotic plaque is defined as the focal structure invading the arterial cavity with a size of at least 0.5 mm or at least 50% greater than the thickness of the surrounding vessel wall (iv) Compared with the control group, the incidence of lower extremity vascular diseases in dorsal artery was higher than that in pop artery in type 2 diabetes mellitus group (v) The findings are stated with statistical parameters in results section
Summary
Lower extremity vascular disease (LEAD) is the main manifestation of peripheral artery disease. Lower extremity vascular diseases in patients with diabetes mellitus generally cannot be detected clinically in the early stages due to the common complications of neuropathy [2, 3]. It can detect and distinguish the formation of carotid atherosclerotic plaque and find out the potential risk factors of patients with diabetes mellitus to provide basis for early clinical diagnosis, treatment, rehabilitation, and intervention [9,10,11]. The purpose of this study is to discuss the association between ultrasonic manifestations of lower extremity vascular disease and plaque formation, plus the association between the coronary artery and carotid artery atherosclerosis in patients with type 2 diabetes mellitus, so as to guide the clinical diagnosis and treatment
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