Abstract
Objectives: The main aim of the study was to find the association between obesity and other anthropometric indices with symptomatic peripheral arterial disease (PAD) in type 2 diabetes mellitus (T2DM) patients. Furthermore, we investigated other risk factors of symptomatic PAD in T2DM. Study Design: In a case-control design, 46 cases and 69 controls were enrolled, aged between 40 and 75 years. Cases were age and gender matched with controls. Ankle-brachial index (ABI) <0.9 was a proxy for PAD in T2DM patients. Anthropometric indices were measured and known cardiovascular risk factors were collected, area under curve (AUC) and logistic regression were applied. Results: Hypertensive patients had 2.5 fold higher risk of symptomatic PAD than normotensive patients, (CI 95%=1.16-5.51). Smoking habit was remarkably higher in cases than controls, OR=8.2 CI 95% (3.2-8.2), however this was not significant in smoking subgroups based on duration of smoking (pack-year). Waste hip ratio (WHR) ≥1 in both male and female was significantly related to the outcome, Odds ratio 3.12 (CI 95% 1.25-7.82) in men and of 26.67 (CI 95% 3.77-188.51) in women. In the final model (forward stepwise regression), WHR ≥ 1, hypertension, duration of DM and Smoking were significantly related to symptomatic PAD. Conclusion: As obese patients are more prone to type 2 diabetes mellitus, the previous cut-offs of obesity may change in the future to assess the risk of CVD in this group. We suggest that WHR is a simple measure of abdominal obesity and is related to symptomatic PAD.
Highlights
As obese patients are more prone to type 2 diabetes mellitus, the previous cut-offs of obesity may change in the future to assess the risk of CVD in this group
We suggest that WHR is a simple measure of abdominal obesity and is related to symptomatic Peripheral artery disease (PAD)
Peripheral artery disease (PAD) in terms of atherosclerosis of lower extremity vessels below aortic bifurcation is considered to be an important marker of cardiovascular disease
Summary
Peripheral artery disease (PAD) in terms of atherosclerosis of lower extremity vessels below aortic bifurcation is considered to be an important marker of cardiovascular disease. Increasing prevalence, concomitant morbidity/mortality and misleading symptoms of PAD has urged the physician to increase their awareness about diagnosis and treatment of PAD. In previous published review on the epidemiology of PAD, the mean prevalence was 15.6% and 13.4% in women and men, respectively [1]. Anklebrachial index (ABI) is a simple, reliable and non-invasive test to detect PAD in at risk population. Cut-off value of 0.9 is an accepted threshold for PAD diagnosis [2]. Sensitivity and specificity of 95% and 100% in general population [3], and 70.6% and 88.5% in type 2
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