CMRI Diabetes and Metabolic Research Program, Harold Hamm Oklahoma Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA.
J Vasc Surg. 2010 Mar;51(3):610-5. doi: 10.1016/j.jvs.2009.09.059.
To assess the gender and ethnic differences in arterial compliance in patients with intermittent claudication.
A total of 114 patients participated, including 38 Caucasian men, 32 Caucasian women, 16 African American men, and 28 African American women. Patients were assessed on large artery elasticity index (LAEI), small artery elasticity index (SAEI), age, weight, body mass index, ankle-brachial index (ABI), smoking status, and metabolic syndrome components.
Group differences were found for LAEI (P = .042), SAEI (P = .019), body mass index (P = .020), prevalence of elevated fasting glucose (P = .001), and prevalence of abdominal obesity (P = .025). Significant covariates for LAEI included age (P = .0002) and elevated triglycerides (P = .0719). LAEI (units = 10 mL x mm Hg) adjusted for age and triglycerides was 39% lower (P = .0005) in African Americans (11.4 +/- .90; mean +/- SE) than in Caucasians (15.8 +/- 0.72), whereas no significant difference (P = .7904) existed between men (13.8 +/- 0.81) and women (13.5 +/- 0.79). Significant covariates for SAEI included age (P = .0001), abdominal obesity (P = .0030), and elevated blood pressure (P = .0067). SAEI (units = 100 mL x mm Hg) adjusted for age, abdominal obesity, and elevated blood pressure was 32% lower (P = .0007) in African-Americans (2.8 +/- 0.3) than in Caucasians 4.1 +/- 0.2), and was 18% lower (P = .0442) in women (3.1 +/- 0.2) than in men (3.8 +/- 0.2).
African American patients with intermittent claudication have more impaired macrovascular and microvascular function than Caucasian patients, and women have more impaired microvascular function than men. These ethnic and gender differences in arterial compliance are evident even though ABI was similar among groups, suggesting that arterial compliance provides unique information to quantify vascular impairment in patients with intermittent claudication.
评估间歇性跛行患者的动脉顺应性的性别和种族差异。
共有 114 名患者参与,包括 38 名白种男性、32 名白种女性、16 名非裔美国男性和 28 名非裔美国女性。评估患者的大动脉弹性指数(LAEI)、小动脉弹性指数(SAEI)、年龄、体重、体重指数、踝臂指数(ABI)、吸烟状况和代谢综合征成分。
组间差异在 LAEI(P=.042)、SAEI(P=.019)、体重指数(P=.020)、空腹血糖升高的患病率(P=.001)和腹型肥胖的患病率(P=.025)方面存在差异。LAEI 的显著协变量包括年龄(P=.0002)和升高的甘油三酯(P=.0719)。调整年龄和甘油三酯后,非裔美国人的 LAEI(单位为 10 mL x mm Hg)降低了 39%(P=.0005),为 11.4 +/-.90(平均值 +/- SE),而白种人之间无显著差异(P=.7904),为 13.8 +/- 0.81(男性)和 13.5 +/- 0.79(女性)。SAEI 的显著协变量包括年龄(P=.0001)、腹型肥胖(P=.0030)和血压升高(P=.0067)。调整年龄、腹型肥胖和血压后,非裔美国人的 SAEI(单位为 100 mL x mm Hg)降低了 32%(P=.0007),为 2.8 +/- 0.3,而白种人则为 4.1 +/- 0.2,女性(3.1 +/- 0.2)比男性(3.8 +/- 0.2)降低了 18%(P=.0442)。
间歇性跛行的非裔美国患者的大血管和微血管功能比白种患者受损更严重,而女性的微血管功能比男性受损更严重。即使 ABI 在各组之间相似,这些动脉顺应性的种族和性别差异仍然存在,表明动脉顺应性提供了量化间歇性跛行患者血管损伤的独特信息。