Abstract
Background. Peripheral arterial disease (PAD) is a major risk factor for nonhealing foot ulcers in people with diabetes. A number of traditional risk factors have been reported to be associated with PAD; however, there may be a need to consider nontraditional risk factors especially in some vulnerable populations. This study determined the prevalence and risk factors associated with PAD in diabetics. Methods. One hundred and fifty type 2 diabetics and an equal number of age- and sex-matched apparently healthy controls were studied. Assessment of PAD was made using history, palpation of lower limb vessels, and measurement of ankle-brachial index (ABI). Statistically significant differences between categorical and continuous variables were determined using Chi square (χ 2) and Student t-tests, respectively. Regression analysis was done to determine the associated risk factors for PAD. Results. Prevalence of PAD using ABI was 22.0% and 8.0% among diabetic and nondiabetic populations, respectively. Peripheral arterial disease was associated with age, male gender, waist circumference, and high-sensitivity C-reactive protein. Conclusion. This study highlights the high prevalence of PAD in people with type 2 diabetes mellitus and in apparently healthy controls; age, male gender, abdominal obesity, and high hs-CRP values were the associated risk factors.
Highlights
Peripheral arterial disease (PAD) reflects systemic atherosclerosis and is associated with long-term disability and increased cardiovascular complications [1,2,3]
Since the major risk factors such as diabetes and smoking do not explain the increased occurrence of critical limb ischaemia, there is a need to further investigate the contribution of nontraditional factors such as inflammation to peripheral arterial disease
Intermittent claudication may not be a true indicator of PAD due to the presence of physical impairment and cardiovascular diseases in people with PAD, resulting in their inability to walk far or fast enough to experience muscle ischaemia which brings about intermittent claudication [21, 22]
Summary
Peripheral arterial disease (PAD) reflects systemic atherosclerosis and is associated with long-term disability and increased cardiovascular complications [1,2,3]. Since the major risk factors such as diabetes and smoking do not explain the increased occurrence of critical limb ischaemia, there is a need to further investigate the contribution of nontraditional factors such as inflammation to peripheral arterial disease. This study assessed the contribution of inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) and white blood cells, to the occurrence of PAD. These have not been previously studied in relation to PAD among indigenous Nigerians. This study highlights the high prevalence of PAD in people with type 2 diabetes mellitus and in apparently healthy controls; age, male gender, abdominal obesity, and high hs-CRP values were the associated risk factors
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