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2007, Number 2

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Rev Med Inst Mex Seguro Soc 2007; 45 (2)

Differences of Risk Factors for Peripheral Arterial Disease in Type 2 Diabetes Patients in Urban and Suburban Populations

Contreras-Téllez EJ, Rodríguez-Moctezuma JR, López-Carmona JM, Munguía-Miranda C, Aranda-Moreno C, Peralta-Pedrero ML

Language: Spanish
References: 23
Page: 117-122
PDF size: 158.76 Kb.


ABSTRACT

Objectives: to determine the prevalence of peripheral arterial disease (PAD) in type 2 diabetes patients and to measure the strength of the association of selected risk factors.
Methodology: a cross-sectional study including two hundred and fifty-two type 2 diabetes patients older than 40 years was conducted in three family medicine clinics, one clinic located within the city and two clinics in the suburb. PAD was diagnosed by Doppler pulsed in the patients with an ankle/arm index ‹ 0.9. Clinical variables: serum cholesterol and triglycerides levels, body mass index (BMI), waist-hip index (WHI), blood pressure (BP) and fasting blood glucose average of the last six months. To ascertain the differences in the prevalence of PAD, χ2 test was used; t test was used for quantitative variables; and to estimate the risks the odds ratios were calculated.
Results: among urban population the prevalence of PAD was of 25.6 % while for those living in the suburb was 9.8 % (p = 0.002). Serum levels of blood glucose and cholesterol were lower in the latter (p = 0.01 and p = 0.001 respectively). PAD was associated with serum blood glucose levels higher than 140 mg/dL (OR = 3.1; 95 % CI: 1-9.7); total cholesterol higher than 200 mg/dL (OR = 2.8; 95 % CI: 1.1-7.4); proteinuria (OR = 4.9; 95 % CI: 1.7-30.6) and blood pressure higher than 140/90 mm Hg (OR = 2.11; 95 % CI: 1.08-4.14)
Conclusions: prevalence of PAD was higher in type 2 diabetes patients receiving care in urban clinics when compared to those cared for at suburban family medicine clinics and its corresponding risk factors showed significant values.


REFERENCES

  1. Wissler RW. Theories and new horizons in the pathogenesis of atherosclerosis and the mechanisms of clinical effects. Arch Pathol Lab Med 1992;116:1281-1291.

  2. Ross R, Glomset JA. The pathogenesis of atherosclerosis. N Engl J Med 1976;295(7):369-377.

  3. Fowkes RG, Housley E, Cawood EH, Macintyre CC, Ruckley CV, Prescott RJ. Edinburgh Artery Study: Prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiology 1991; 20:384-392.

  4. Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager NA, Olin JW et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 2001; 286:1317-1324.

  5. Weitz JI, Byrne J, Clagett GP, Farkouh ME, Porter JM, Sackett DL et al. Diagnosis and treatment of chronic arterial insufficiency of lower extremities: a critical review. Circulation 1996; 94:3026-3049.

  6. Criqui MH, Langer RD, Fronek A, Feigelson HS, Klauber MR, McCann TJ, Browner D. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med 1992;326:381-386.

  7. McDermott MM, Lui K, Guralnik JM, Shuti M, Criqui MH, Martin GJ, Greenland P. The ankle brachial index independently predicts walking velocity and walking endurace in peripheral arterial disease. J Am Geriatr Soc 1998;46(11):1355-1362.

  8. Dormandy JA, Rutherford RD. Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC). J Vasc Surg 2000;31:S1-S296.

  9. Newman AB, Siscovick DS, Manolio TA, Polak J, Linda PF, Nemat OB, Sidney K. Atherosclerosis: ankle-arm index as a marker of atherosclerosis in the cardiovascular health study. Circulation 1993;88(3):837-845.

  10. Leng GC, Fowkes FGR. The Edinburgh claudication questionnaire: An improved version of the WHO/Rose questionnaire for use in epidemiological surveys. J Clin Epidemiol 1992;45: 1101-1109.

  11. Dormandy J, Heeck L, Vig S. Intermittent claudication: a condition with underrated risk. Semin Vasc Surg 1999;12:96-108.

  12. Fabsitz RR, Sidawy AN, Lee ET, Welty TK, Devereux RB, Howardo BV. Prevalence of peripheral arterial disease and associated risk factors in American Indians, the Strong Heart Study. Am J Epidemiol 1999;149:330-338.

  13. Fernández-Antoli P, Canalejo-Raya MA. Uso del Doppler portátil en patología vascular en atención primaria. Atencion Primaria 1998; 22:467-467.

  14. Sebastián-Aparicio MP, Fernández de Leceta-Pinedo P, Arenas-Aguirregoitia C. Vasculopatía arterial periférica: pautas de actuación en atención primaria. Atencion Primaria 1998;54:36.

  15. Buitrón-Granados LV, Martínez-López CM, Escobedo-de la Peña J. Prevalence of peripheral arterial disease and related risk factors in an urban Mexican population. Angiology 2004;55:43-51.

  16. American Diabetes Association. Peripheral arterial disease in peoples with diabetes. (Consensus Statement). Diabetes Care 2003;26:3333-3341.

  17. Gregg EW, Sorlie P, Paulose-Ram R, Gu Q, Eberhardt MS, Wolz M, Burt V, Curtin L, Engelgau M, Geiss L. Prevalence of lower extremity disease in the U.S. adult population > 40 years of age with and without diabetes. 1999-2000 National Health and Nutrition Examination Survey. Diabetes Care 2004;27:1591-1597.

  18. Gallotta G, Iazzetta N, Milan G, Ruocco A, Napoli C, Postiglione A. Prevalence of peripheral arterial disease in an elderly rural population of Southern Italy. Gerontology 1997;43:289-295.

  19. 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 atheroschlerosis compared with ischemic heart disease in the Edinburgh Artery Study. Am J Epidemiol 1992;135:331-340.

  20. Lambert J, Smulders RA, Aarsen M, Donker JM, Stehouwer CD. Carotid artery stiffness is increased in microalbuminuric IDDM patients. Diabetes Care 1998;21(1):99-103.

  21. Hoogeveen EK, Kostense PJ, Beks PJ. Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease, especially in non-insulin-dependent diabetes mellitus: a population-based study. Arterioscler Thromb Vasc Biol 1998;18:133-138.

  22. Cupples LA, Gagnon DR, Wong ND, Ostfeld AM, Kannel WB. Preexisting cardiovascular conditions and long-term prognosis after initial myocardial infarction: The Framingham Study. Am Heart J 1993;125:863-872.

  23. Belch J, Topol E, Agnelli G, Beltrand M, Califf, Denis LC. Prevention of Atherothrombotic Disease Network. Critical issues in peripheral arterial disease detection and management. A call to action. Arch Intern Med 2003;163:884-892.




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