2021, Number 3
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Revista Cubana de Angiología y Cirugía Vascular 2021; 22 (3)
Screening for asymptomatic peripheral artery disease in patients with type 2 diabetes mellitus
Pérez PA, Barnés DJA, García GY, González HO
Language: Spanish
References: 67
Page: 1-29
PDF size: 381.08 Kb.
ABSTRACT
Introduction:
Diabetes mellitus modifies the natural history of atherosclerosis. Therefore, the impact of this process on the different vascular beds is the main cause of morbidity and mortality in these patients.
Objectives:
Determine the frequency of asymptomatic peripheral artery disease in people with type 2 diabetes mellitus, its relationship with other clinical variables of diabetes and complications of the disease.
Methods:
A cross-sectional descriptive study was conducted at Cerro polyclinic with a total of 100 type 2 diabetic patients aged between 40 and 70 years in a period of one year (2019), without prior diagnosis of peripheral arterial disease or foot injuries. Peripheral pulses of the lower limbs were examined and the ankle-brachial pressure index was calculated.
Results:
36 patients with low rates were identified, which was consistent with asymptomatic peripheral arterial disease (36 %). Smoking habit was significantly related to the presence of low rates (p = 0.02), but there were no significant differences with respect to age, sex, skin color, time of evolution of diabetes, consumption of alcoholic beverages, physical activity, high blood pressure and obesity. Most patients had a slight affectation regarding severity.
Conclusions:
Asymptomatic peripheral artery disease is a common complication in people with type 2 diabetes.
REFERENCES
Rawshani A, Rawshani A, Franzén S, Eliasson B, Svensson AM, Miftaraj M, et al. Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes. N Engl J Med. 2017 [acceso 20/10/2019];376(15):1407-18. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/28402770/
Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res. 2015;116(9):1509-26. DOI: https://doi.org/10.1161/CIRCRESAHA.116.303849
Gibbons GW, Shaw PM. Diabetic vascular disease: characteristics of vascular disease unique to the diabetic patient. SeminVasc Surg. 2012 [acceso 22/06/2019];25(2):89-92. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/22817858/
Marone EM, Cozzolino P, Ciampichini R, Chiodini V, Ferraresi R, Rinaldi LF, et al. Peripheral arterial disease in diabetic patients: a long-term population-based study on occurrence, outcomes and cost. J Cardiovasc Surg (Torino). 2018;59(4):572-9. DOI: https://doi.org/10.23736/S0021-9509.18.10405-8
Vicente I, Lahoz C, Taboada M, Laguna F, García-Iglesias F, Mostaza Prieto JM. Índice tobillo-brazo en pacientes con diabetes mellitus: prevalencia y factores de riesgo. Rev Clin Esp. 2006 [acceso 12/07/2019];206(5):225-9. Disponible en: Disponible en: https://www.revclinesp.es/es-indice-tobillo-brazo-pacientes-con-diabetes-articulo-13088561
Bundó M, Muñoz L, Pérez C, Montero JJ, Montellá N, Torán P, et al. Asymptomatic peripheral arterial disease in type 2 diabetes patients: a 10-year follow-up study of the utility of the ankle brachial index as a prognostic marker of cardiovascular disease. Ann Vasc Surg. 2010;24(8):985-93. DOI: https://doi.org/10.1016/j.avsg.2010.06.001
Mancera J, Paniagua F, Martos I, Baca A, Ruiz S, Gonzalez P, et al. Enfermedad arterial periférica oculta en población diabética seguida en atención primaria. ClinInvest Arterioscl. 2010 [acceso 13/08/2019];22:154-61. Disponible en: Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=3256928
Manzano L, Mostaza JM, Suárez C, Cairols M, Redondo R, Valdivielso P, et al. Modificación de la estratificación del riesgo vascular tras la determinación del índice tobillo-brazo en pacientes sin enfermedad arterial conocida. Estudio MERITO. MedClin (Barc). 2007 [acceso 08/12/2019];128:241-6. Disponible en: Disponible en: https://medes.com/publication/25315
Escobar C, Blanes I, Ruiz A, Vinuesa D, Montero M, Rodríguez M, et al. Prevalence and clinical profile and management of peripheral arterial disease in elderly patients with diabetes. Eur J Intern Med. 2011;22:275-81. DOI: https://doi.org/10.1016/j.ejim.2011.02.001
American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003 [acceso 14/06/2019];26:3333-41. Disponible en: Disponible en: https://care.diabetesjournals.org/content/26/12/3333
Rivero FE, Escalante O, Rivero T, Morales N, Lazo I. Rol de los factores de riesgo mayores en la macroangiopatía diabética de miembros inferiores. Rev Cubana Angiol y Cir Vasc. 2002 [acceso 22/10/2015];3:24-9. Disponible en: Disponible en: http://bvs.sld.cu/revistas/ang/vol3_2_02/ang04202.htm
Ricardo A, Rodríguez G, Fletcher Z, González A. Prevalencia de la macroangiopatía diabética en un área de salud del municipio Banes, Holguín. Rev Cubana Angiol y Cir Vasc. 2003 [acceso 22/10/2015];4(1). Disponible en: Disponible en: http://bvs.sld.cu/revistas/ang/vol4_1_03/ang13103.htm
Llanes JA, Fernández JI, Seuc AH, Chirino N, Hernández MJ. Caracterización del pie diabético y algunos de sus factores de riesgo. Rev Cubana Angiol y Cir Vasc. 2010 [acceso 22/10/2015];11(1). Disponible en: Disponible en: http://bvs.sld.cu/revistas/ang/vol11_01_10/ang02110.htm
Valdés ER, Espinosa Y. Factores de riesgo asociado con la aparición de enfermedad arterial periférica en personas con diabetes mellitus tipo 2. Rev Cubana Med. 2013 [acceso 22/10/2015];52(1):4-13. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 75232013000100002&lng=es&nrm=iso&tlng=es
Agarwal AK, Singh M, Arya V, Garg U, Singh VP, Jain V. Prevalence of peripheral arterial disease in type 2 diabetes mellitus and its correlation with coronary artery disease and its risk factors. J Assoc Physicians India. 2012 [acceso 22/10/2015];60:28-32. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/23405538/
Diehm C, Allenberg JR, Pittrow D, Mahn M, Tepohl G, Haberl RL, et al. Mortality and vascular morbidity in older adults with asymptomatic versus symptomatic peripheral artery disease. Circulation. 2009 [acceso 22/10/2015];120:2053-61. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/23405538/
McKenna M, Volfson S, Kuller L. The ratio of ankle and arm arterial pressure as an independent predictor of mortality. Atherosclerosis. 1991;87:119-28.
Forbang NI, McDermott MM, Liao Y, Ix JH, Allison MA, Liu K, et al. Associations of Diabetes Mellitus and Other Cardiovascular Disease Risk Factors with Decline in the Ankle Brachial Index. Vasc Med. 2014;19:465-72. DOI: https://doi.org/10.1177/1358863X14554033
Wilcox T, Newman JD, Maldonado TS, Rockman C, Berger JS. Peripheral vascular disease risk in diabetic individuals without coronary heart disease. Atherosclerosis. 2018;(18):30211-9. DOI: https://doi.org/10.1016/j.atherosclerosis.2018.04.026
Adler AI, Stevens RJ, Neil A, Stratton IM, Boulton AJ, Holman RR. UKPDS 59: hyperglycemia and other potentially modifiable risk factors for peripheral vascular disease in type 2 diabetes. Diabetes Care. 2002;25:894-9. DOI: https://doi.org/10.2337/diacare.25.5.894
Soyoye DO, Ikem RT, Kolawole BA, Oluwadiya KS, Bolarinwa RA, Adebayo OJ. Prevalence and Correlates of Peripheral Arterial Disease in Nigerians with Type 2 Diabetes. Adv Med. 2016;3529419. DOI: https://doi.org/10.1155/2016/3529419
Abbott RD, Brand FN, Kannel WB. Epidemiology of some peripheral arterial findings in diabetic men and women: experiences from the Framingham Study. Am J Med. 1990;88:376-81.
Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, et al. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med. 2004;141(6):421-31. DOI: https://doi.org/110.7326/0003-4819-141-6-200409210-00007
Gerhard-Herman MD, Gornik HL, Barrett C, Corriere MA, Drachman DE, Barshes NR, et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135(12):e726-e79. DOI: https://doi.org/10.1161/CIR.0000000000000470
Aboyans V, Ricco JB, Bartelink MEL, Björck M, Brodmann M, Cohnert T, et al. ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS): document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) the task force for the diagnosis and treatment of peripheral arterial diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018,39(1):763-816. DOI: https://doi.org/10.1093/eurheartj/ehx095
Hajibandeh S, Shah S, Child E, Antoniou GA, Torella F. Prognostic significance of ankle brachial pressure index: A systematic review and meta-analysis. Vascular. 2016;91:764-8. DOI: https://doi.org/10.1177/1708538116658392
Kumar MS, Lohiya A, Ramesh V, Behera P, Palepu S, Rizwan SA. Sensitivity and Specificity of Pulse Oximetry and Ankle-Brachial Index for Screening Asymptomatic Peripheral Vascular Diseases in Type 2 Diabetes Mellitus. J Assoc Physicians India. 2016 [acceso 14/06/2019];64(8):38-43. Disponible en: Disponible en: https://www.japi.org/r2a49444/sensitivity-and-specificity-of-pulse-oximetry-and-ankle-brachial-index-for-screening-asymptomatic-peripheral-vascular-diseases-in-type-2-diabetes-mellitus
Yan BP, Zhang Y, Kong APS, Luk AOY, Ozaki R, Yeung R, et al. Borderline ankle-brachial index is associated with increased prevalence of micro- and macrovascularcomplications in type 2 diabetes: A cross-sectional analysis of 12,772 patients from the Joint Asia Diabetes Evaluation Program. Diab Vasc Dis Research. 2015;12(5)334-41. DOI: https://doi.org/10.1177/1479164115590559
Natsuaki C, Inoguchi T, Maeda Y. Association of borderline ankle-brachial index with mortality and the incidence of peripheral artery disease in diabetic patients. Atherosclerosis. 2014;234(2):360-5. DOI: https://doi.org/10.1016/j.atherosclerosis.2014.03.018
Aboyans V, Ricco JB, Bartelink MLEL, Björck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). European HeartJournal. 2018;39(9):763-816. DOI: https://doi.org/10.1093/eurheartj/ehx095
World Health Organization. Consultation on Obesity. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000 [acceso 14/06/2019];894:1-253. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/11234459/
Felício JS, Cavalcante C, Abdallah N, Resende FS, Nascimento de Lemos M, Corrêa RJM, et al. Ankle-brachial index and peripheral arterial disease: An evaluation including a type 2 diabetes mellitus drug-naïve patients cohort. Diab Vasc Dis Res. 2019;16(4):344-50. DOI: https://doi.org/10.1177/1479164119829385
Mancera J, Paniagua F, Martos I, Baca A, Ruiz S, Gonzalez P, et al. Enfermedad arterial periférica oculta en población diabética seguida en atención primaria. Clin Invest Arterioscl. 2010 [acceso 14/06/2019];22(4):154-61. Disponible en: Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=3256928
Rhee SY, Guan H, Liu ZM. Multi-country study on the prevalence and clinical features of peripheral arterial disease in Asian type 2 diabetes patients at high risk of atherosclerosis. Diabetes Res Clin Pract. 2007;76:82-92. DOI: https://doi.org/10.1016/j.diabres.2006.07.029
Rabia K, Khoo EM. Prevalence of peripheral arterial disease in patients with diabetes mellitus in a primary care setting. Med J Malaysia. 2007 [acceso 14/06/2019];62:130-3. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/18705445/
Roca MM, Carral F, Baena G, Sánchez Z, Valencia I, Aguilar M. Evaluación de la enfermedad vascular periférica en pacientes con diabetes tipo 2 mediante medición del índice tobillo-brazo. AvDiabetol. 2007 [acceso 14/06/2019];23(5):370-4. Disponible en: Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=2497351
Puras-Mallagray E, Gutierrez-Baz M, Cáncer-Pérez S, Alfayate-García JM, de Benito-Fernández L, Perera-Sabio M, et al. Estudio de prevalencia de la enfermedad arterial periférica y diabetes en España. Angiología. 2008 [acceso 14/06/2019];60(5):317-26. Disponible en: Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=2742315
Tummalaa R, Banerjeeb K, Mahajana K, Ravakhaha K, Gupta A. Utility of ankle-brachial index in screening for peripheral arterial disease in rural India: A cross-sectional study and review of literatura. Indian Heart Journal. 2018;70(2):323-5. DOI: https://doi.org/10.1016/j.ihj.2017.07.012
Tanaka S, Kaneko H, Kano H, Matsuno S, Suzuki S, Takai H. The predictive value of the borderline ankle-brachial index for long-term clinical outcomes: An observational cohort study. Atherosclerosis. 2016;250:69-76. DOI: https://doi.org/10.1016/j.atherosclerosis.2016.05.014
Kajikawa M, Maruhashi T, Iwamoto Y, Iwamoto A, Matsumoto T, Hidaka T, et al. Borderline Ankle-Brachial Index Value of 0.91-0.99 Is Associated With Endothelial Dysfunction. Circ J. 2014;78(7):1740-5. DOI: https://doi.org/10.1253/circj.cj-14-0165
Korhonen P, Aarnio P. Borderline peripheral arterial disease. Int J Angiol. 2008;17(4):175-7. DOI: https://dx.doi.org/10.1055%2Fs-0031-1278304
Menke A, Muntner P, Wildman RP, et al. Relation of borderline peripheral arterial disease to cardiovascular disease risk. Am J Cardiol. 2006;98(9):1226-30. DOI: https://dx.doi.org/10.1016/j.amjcard.2006.05.056
García García Y, Guerra Formigo L, Domínguez Alonso E, González Hernández O, Acosta Cedeño A, Conesa González A. Enfermedad arterial periférica asintomática en personas con diabetes de tipo 2. Rev Cubana Ang Cir Vasc. 2020 [acceso 14/06/2019];21(3). Disponible en: Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1682-00372020000300002
Marone EM, Cozzolino P, Ciampichini R, Chiodini V, Ferraresi R, Rinaldi LF, et al. Peripheral arterial disease in diabetic patients: a long-term population-based study on occurrence, outcomes and cost. J Cardiovasc Surg (Torino). 2018;59(4):572-9.
Jelani Q, Petrov M, Martinez SC, Holmvang L, Al-Shaibi K, Alasnag M. Peripheral Arterial Disease in Women Atherosclerosis Reports. Current Atherosclerosis Reports. 2018;20(8):40-4. DOI: https://dx.doi.org/10.1007%2Fs11883-018-0742-x
Singh S, Bailey KR, Kullo IJ. Ethnic differences in ankle brachial index are present in middle-aged individuals without peripheral arterial disease. Int J Cardiol. 2013;162(3):228-33. DOI: https://doi.org/10.1016/j.ijcard.2011.05.068
Al-Delaimy WK, Merchant AT, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Effect of type 2 diabetes and its duration on the risk of peripheral arterial disease among men. Am J Med. 2004;116(4):236-40. DOI: https://doi.org/10.1016/j.amjmed.2003.09.038
Zander E, Heinke P, Reindel J, Kohnert KD, Kairies U, Braun J, et al. Peripheral arterial disease in diabetes mellitus type 1and type 2: are there different risk factors? Vasa. 2002;31:249-54. DOI: https://doi.org/10.1024/0301-1526.31.4.249
García García Y, Díaz Batista A, Arpajón Peña Y, Aldama Figueroa A, Conesa González AI, del Busto Mesa A. Enfermedad arterial periférica asintomática en pacientes con factores de riesgo del síndrome metabólico. Rev Cubana Angiol CirVasc. 2018;19(2). Disponible en: http://scielo.sld.cu/pdf/ang/v19n2/ang04218.pdf
Athyros VG, Liberopoulos EN, Mikhailidis DP, Papageorgiou AA, Ganotakis ES, Tziomalos K, et al. Association of Drinking Pattern and Alcohol Beverage Type With the Prevalence of Metabolic Syndrome, Diabetes, Coronary Heart Disease, Stroke, and Peripheral Arterial Disease in a Mediterranean Cohort. Angiology. 2008;58:689-97.
McDermott MM, Greenland P, Liu K, Guralnik JM, Celic L, Criqui MH, et al. The ankle brachial index is associated with leg function and physical activity: the Walking and Leg Circulation Study. Ann InternMed. 2002;136:873-83. DOI: https://doi.org/10.7326/0003-4819-136-12-200206180-00008
Fowkes FG, Housley E, Riemersma RA, Macintyre CC, Cawood EH, Prescott RJ. et al. Smoking, lipids, glucose intolerance, and blood pressure as risk factors for peripheral atherosclerosis compared with ischemic heart disease in the Edinburgh Artery Study. Am J Epidemiol. 1992;135:331-40.
Ostchega Y, Paulose-Ram R, Dillon CF, Gu Q, Hughes JP. Prevalence of peripheral arterial disease and risk factors in persons aged 60 and older: data from the National Health and Nutrition Examination Survey 1999-2004. J Am Geriatr Soc. 2007;55:583-9.
Holman RR, Paul SK, Bethel MA, Neil HA, Matthews DR. Long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med. 2008;359:1565-76.
Emdin CA, Anderson SG, Callender T, Conrad N, Salimi-Khorshidi G, Mohseni H, et al. Usual blood pressure, peripheral arterial disease, and vascular risk: cohort study of 4.2 million adults. BMJ. 2015;351:h4865. DOI: http://dx.doi.org/10.1136/bmj.h4865
Puig T, Ferrero-Gregori A, Roig E, Vázquez R, Gonzalez-Juanatey JR, Pascual-Figal D, et al. Valor pronóstico del índice de masa corporal y el perímetro de cintura en los pacientes con insuficiencia cardiaca crónica (Registro Español REDINSCOR). Rev Esp Cardiol. 2014;67(2):101-6. DOI: http://dx.doi.org/10.1016/j.recesp.2013.06.025
Azimi A, Charlot MG, Torp-Pedersen C, Gislason GH, Køber L, Jensen LO, et al. Moderate Overweight Is Beneficial and Severe Obesity Detrimental for Patients With Documented Atherosclerotic Heart Disease. Heart. 2013;99(9):655-60. DOI: https://doi.org/10.1136/heartjnl-2012-303066
Tobias DK, Pan A, Jackson CL, O'Reilly EJ, Ding EL, Willett WC, et al. Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes. N Engl J Med. 2014;370(3):233-44. DOI: https://doi.org/10.1056/nejmoa1304501
Tobias DK. Addressing Reverse Causation Bias in the Obesity Paradox Is Not “One Size Fits All”. Diabetes Care. 2017;40(8):1000-1. DOI: https://doi.org/10.2337/dci17-0010
Alzamora M, Forés R, Baena-Díez J, Pera G, Toran P, Sorribes M, et al. The Peripheral Arterial disease study (PERART/ARTPER): prevalence and risk factors in the general population. BMC Public Health. 2010;10:38-42. Disponible en: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-10-38
Ix JH, Biggs ML, Kizer JR, Mukamal KJ, Djousse L, Zieman SJ. Association of body mass index with peripheral arterial disease in older adults. Am J Epidemiol. 2011;174(9):1036-43. DOI: https://doi.org/10.1093/aje/kwr228
Criqui MH, Fronek A, Klauber MR, Barrett-Connor E, Gabriel S. The sensitivity, specificity, and predictive value of traditional clinical evaluation of peripheral arterial disease: results from noninvasive testing in a defined population. Circulation. 1985;71:516-522.
Azzopardi YM, Gatt A, Chockalingam N, Formosa C. Agreement of clinical tests for the diagnosis of peripheral arterial disease. Prim Care Diab. 2019;13:82-6. DOI: https://doi.org/10.1016/j.pcd.2018.08.005
Vriens B, D’Abate F, Ozdemir BA, Fenner C, Maynard W, Budge J, et al. Clinical examination and non-invasive screening tests in the diagnosis of peripheral artery disease in people with diabetes-related foot ulceration. Diabet Med. 2018;35(7):895-902. DOI: https://doi.org/10.1111/dme.13634
Mohammedi K, Woodward M, Zoungas S, Li Q, Harrap S, Patel A, et al. Absence of Peripheral Pulses and Risk of Major Vascular Outcomes in Patients With Type 2 Diabetes. Diab Care. 2016;39(12):2270-7. DOI: https://doi.org/10.2337/dc16-1594
Frank U, Nikol S, Belch J, Boc V, Brodmann M, Carpentier PH. European Society for Vascular Medicine (ESVM)-Guidelineonperipheral arterial disease. VASA. 2019;48(102):1-79. DOI: https://doi.org/10.1024/0301-1526/a000834
Armstrong DWJ, Tobin C, Matangi MF. The accuracy of the physical examination for the detection of lower extremity peripheral arterial disease. Can J Cardiol. 2010;26(10):e346-e350. DOI: https://doi.org/10.1016/s0828-282x(10)70467-0