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Diabetic foot (DF) syndrome is the most common lower-extremity complication of poorly controlled type 2 diabetes (T2D)(1). DF affects the quality of life of T2D patients and is associated with increased morbidity (2). T2D-related mechanisms induce endothelial dysfunction and adverse effects on vascular biology (3). We have recently shown that measurements of endothelial function and arterial stiffness are strongly associated with diabetic retinopathy (4), but their association with DF has not been explored yet. To examine this, we enrolled 284 consecutive T2D subjects visiting our outpatient diabetes clinic and 196 age-and sex-matched healthy control subjects without evidence of diabetes or cardiovascular or other disease. Subjects with known malignancy, hepatic impairment, or acute or chronic inflammatory disease were excluded from the study. Study protocol was approved by the institutional ethics committee. Endothelial function was assessed by the flow-mediated dilation (FMD) of the brachial artery and carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) were assessed by SphygmoCor (AtCor Medical) as previously described (4). Prevalence of DF was 24.6% among T2D patients. There were no significant differences in age, sex, cardiovascular risk factors (such as smoking, hypertension, and hyperlipidemia), and HbA1c% between T2D with DF and no DF (NDF)(P 5 NS for all). However, DF patients had significantly increased T2D duration compared with NDF patients (19.5 6 1.1 vs. 12.0 6 0.6 years, P 5 0.001). As expected, T2D was associated with lower FMD and increased PWV and AIx compared with subjects …