國家衛生研究院 NHRI:Item 3990099045/1672
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    Title: Effect of angiotensin blockade on the association between albuminuria and peripheral arterial disease in elderly Taiwanese patients with type 2 diabetes mellitus
    Authors: Tseng, CH;Tseng, CP;Tai, TY;Chong, CK
    Contributors: Division of Gerontology Research;Division of Environmental Health and Occupational Medicine
    Abstract: Background The aim of the present study was to examine the impact of the clinical use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) on the association between the urinary albumin/creatinine ratio (ACR) and ankle-brachial index (ABI) or peripheral arterial disease (PAD) in elderly Taiwanese patients with type 2 diabetes mellitus. Methods and Results Two-hundred and ninety patients (108 men, 182 women) aged >= 65 years (mean +/- SD, 71.6 +/- 4.9) were cross-sectionally studied. ACR was expressed as the natural logarithm [ln(ACR)] and divided into normoalbuminuria (< 30.0 mu g/mg) and albuminuria (>= 30.0 mu g/mg). ABI was evaluated both continuously and as peripheral arterial disease (PAD)(-) and PAD(+) using the cutoff of 0.9. Statistical analyses were performed with consideration of covariates and the use of ACEI/ARB. Results showed that in patients not using ACEI/ARB, In(ACR) negatively correlated with ABI (r=-0.261, p < 0.01) and was associated with ABI with adjusted regression coefficient of -0.0213 (p < 0.05). PAD patients had a significantly higher level of In(ACR) than those without PAD (4.83 +/- 1.34 vs 3.73 +/- 1.29, p < 0.001) and PAD prevalence was significantly higher in those with albuminuria than in those with normoalbuminuria (22.6% vs 4.9%, p < 0.001). The multivariate-adjusted odds ratio for PAD for every 1 unit increment of In (ACR) was 2.10 (1.31-3.38), and for albuminuria vs normoalburninuria 3.86 (1.04-14.31) in patients not using ACEI/ARB. In patients using ACEI/ARB, none of these analyses was significant. Patients using ACEI/ARB had a significantly lower risk of PAD with a multivariate-adjusted odds ratio of 0.34 (0.12-0.97). Conclusions ACR negatively correlates with ABI and is associated with PAD in elderly diabetic patients not treated with ACEI/ARB. The use of ACEI/ARB attenuates this association and may be associated with a lower risk of PAD.
    Keywords: Cardiac & Cardiovascular Systems
    Date: 2005-08
    Relation: Circulation Journal. 2005 Aug;69(8):965-970.
    Link to: http://dx.doi.org/10.1253/circj.69.965
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1346-9843&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000230851200016
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=23744505779
    Appears in Collections:[Tong-Yuan Tai(2003-2005)] Periodical Articles
    [Others] Periodical Articles

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