Abstract
BACKGROUND: Diabetes mellitus (DM) is a risk factor for peripheral arterial disease (PAD). Neither the prevalence of PAD in type 2 (T2) DM nor its detrimental effects on quality of life (QoL) or physical activity (PA) have been well described in the Brazilian population. OBJECTIVES: To evaluate the prevalence of newly diagnosed PAD and its associations with QoL, PA and body composition in a sample of T2DM patients from a University Hospital. METHODS: Seventy-three (73) T2DM patients without previous diagnoses of major complications related to T2DM were enrolled. PAD was assessed using the ankle-brachial index (ABI); QoL was measured using a translated and validated SF-36 questionnaire; PA was measured using a modified Baecke questionnaire; and body composition was measured by segmental multi-frequency bioelectrical impedance. RESULTS: PAD prevalence was 13.7%, predominantly of mild severity (ABI between 0.8-0.9). The ABI results correlated with age (ρ=-0.26, P=0.03), DM duration (ρ=-0.28, P=0.02) and systolic and diastolic blood pressure (ρ=-0.33, P=0.007 and ρ=-0.28, P=0.02; respectively). Scores for the SF-36 physical component summary (PCS) were below the normal range, but no negative impact from PAD was identified by the PCS scores (normal-ABI 42.9±11.2 vs. PAD-ABI 38.12±11.07) or the Baecke PA results. Body composition analysis detected excessive body fat, especially in women, but there was no difference between groups. CONCLUSIONS: The prevalence of previously undiagnosed PAD in this population of T2DM patients was 13.7%, predominantly mild and asymptomatic forms, and was not yet associated with worsened QoL, PA levels or body composition variables.
Highlights
Peripheral arterial disease (PAD) predominantly affects the elderly and prevalence increases with age in both genders.[1,2] Its prevalence in the general population varies from 4 to 10% and can exceed 20% in patients over the age of 70.3 Despite this, there is a low prevalence of symptomatic patients with intermittent claudication.[1,2] Few epidemiologic studies of peripheral arterial disease (PAD) have been conducted in Brazil
There is a strong association between PAD and Diabetes Mellitus (DM),[5,6] but PAD prevalence rates have not been determined in diabetes patients with the same degree of precision as in the general population
No statistical differences were detected when the variables were compared between groups, with the exception of a trend to exhibit higher systolic blood pressure in the PAD ankle-brachial index (ABI) group (P=0.0502)
Summary
Peripheral arterial disease (PAD) predominantly affects the elderly and prevalence increases with age in both genders.[1,2] Its prevalence in the general population varies from 4 to 10% and can exceed 20% in patients over the age of 70.3 Despite this, there is a low prevalence of symptomatic patients with intermittent claudication.[1,2] Few epidemiologic studies of PAD have been conducted in Brazil. There is a strong association between PAD and Diabetes Mellitus (DM),[5,6] but PAD prevalence rates have not been determined in diabetes patients with the same degree of precision as in the general population. Objectives: To evaluate the prevalence of newly diagnosed PAD and its associations with QoL, PA and body composition in a sample of T2DM patients from a University Hospital. Conclusions: The prevalence of previously undiagnosed PAD in this population of T2DM patients was 13.7%, predominantly mild and asymptomatic forms, and was not yet associated with worsened QoL, PA levels or body composition variables
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