High prevalence of asymptomatically poor muscle perfusion of lower extremities measured in type II diabetes patients with abnormal myocardial perfusion

Abstract

Foot problems are the most common cause of hospital admission in patients with type II diabetes mellitus (DM). Poor muscle perfusion of lower extremities is thought to be the major component in the pathogenesis of foot problems. Therefore, it is important and interesting to investigate if high prevalence of poor muscle perfusion of lower extremities in type II DM patients with abnormal myocardial perfusion and more cardiovascular risk factors. We used a well-established and noninvasive radionuclide method (Xe-133 muscle washout) to objectively evaluate the anterior tibial muscle perfusion of 60 type II DM male patients without symptoms/signs of peripheral vascular disease (PVD) in the lower extremities. The patients were separated into groups according to the myocardial perfusion imaging results and cardiovascular risk factor survey. Meanwhile, 30 normal male controls with a matched age distribution were also included for comparison. The muscle perfusions were of significant difference ( P-values <.05) between (1) 60 type II DM patients (1.84±0.43 ml/100 g/min) and 30 normal controls (2.95±0.52 ml/100 g/min), (2) 24 patients with abnormal myocardial perfusion (1.31±0.45 ml/100 g/min) and 36 patients with normal myocardial perfusion (2.24±0.48 ml/100 g/min), as well as (3) 28 patients with more cardiovascular risk factors (1.33±0.46 ml/100 g/min) and 22 patient with less cardiovascular risk factors (2.22±0.49 ml/100 g/min). Based on Xe-133 muscle washout method, we concluded that the muscle perfusion in the lower extremities of type II DM patients without symptoms/signs of PVD is significantly decreased and related to abnormal myocardial perfusion and more cardiovascular risk factors.