Risk Factors for Lower Extremity Arterial Disease in Non-insulin-dependent Diabetic Persons

OBJECTIVE To assess the relationship between body fat distribution and incident lower-extremity arterial disease (LEAD). RESEARCH DESIGN AND METHODS We included 155,925 postmenopausal women with anthropometric measures from the Women’s Health Initiative who had no known LEAD at recruitment. A subset of 10,894 participants had body composition data quantified by dual energy X-ray absorptiometry (DXA). Incident cases of symptomatic LEAD were ascertained and adjudicated via medical record review. RESULTS We identified 1152 incident LEAD cases during a median 18.8 years follow-up. After multivariable adjustment and mutual adjustment, waist and hip circumference was positively and inversely associated with risk of LEAD, respectively (both P-trend values <0.0001). In a subset (n = 22,561) where various cardiometabolic biomarkers were quantified, a similar positive association of waist circumference with risk of LEAD was eliminated after adjustment for diabetes and HOMA-IR (P-trend = 0.89), whereas hip circumference remained inversely associated with the risk after adjustment for major cardiometabolic traits (P-trend = 0.0031). In the DXA subset, higher trunk fat (P-trend = 0.0081) and higher leg fat (P-trend <0.0001) was associated with higher and lower risk of LEAD, respectively. Further adjustment for diabetes, dyslipidemia, and blood pressure diminished the association for trunk fat (P-trend = 0.49), yet the inverse association for leg fat persisted (P-trend = 0.0082). CONCLUSIONS Among US postmenopausal women, a positive association of upper-body fat with risk of LEAD appeared to be attributable to traditional risk factors especially insulin resistance. Lower-body fat was inversely associated with risk of LEAD beyond known risk factors.

Download Full-text

Risk factors of depression in type 2 diabetes mellitus with lower extremity arterial disease in China

10.21203/rs.3.rs-35098/v1 ◽

2020 ◽

Author(s):

Sanbao Chai ◽

Xiaomei Zhang ◽

Ning Yuan ◽

Yufang Liu ◽

Sixu Xin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Lower Extremity ◽

Arterial Disease ◽

Disease Group ◽

Lower Extremity Arterial Disease ◽

Depressive Patients

Abstract BackgroundWe aimed to evaluate the prevalence and risk factors of depression in type 2 diabetes mellitus with lower extremity arterial disease. Methods: Four hundred and forty-one patients with type 2 diabetes mellitus were recruited from Peking University of International Hospital. All patients completed the Self-rating Depression Scale, which includes 20 items, using a 4-point scale. Univariable and multivariable logistic regression was conducted to investigate risk factors of depression in patients with lower extremity arterial disease. Results: The prevalence of depression in lower extremity arterial disease group was significantly higher than that in non- lower extremity arterial disease group(25% vs 16%, P = 0.018). In lower extremity arterial disease group(n = 215), depression score(46.18 ± 7.38 vs 44.03 ± 6.53, P = 0.003) significantly increased compared with non lower extremity arterial disease group(n = 226). Compared with male depressive patients, the proportion of female depressive patients(38% vs 15%, P = 0.003) was significantly higher in lower extremity arterial disease group. The depression score of female depressive patients(57.83 ± 3.29 vs 55.26 ± 1.59, P = 0.003) was significantly higher than that of male depressive patients. An increased risk of depression in female patients(crude OR: 2.50, 95% CI: 1.38–4.54, P = 0.003; adjusted OR: 2.34, 95% CI: 1.26–4.36, P = 0.008) and in patients with low body mass index(crude OR: 0.88, 95% CI: 0.80–0.96, P = 0.005; adjusted OR: 0.89, 95% CI: 0.81–0.97, P = 0.011) was detected. Conclusion: Both low body mass index and female are risk factors for depression.

Download Full-text

Six-year incidence of lower extremity arterial disease and associated risk factors in Type 1 diabetic African-Americans

Diabetic Medicine ◽

10.1111/j.1464-5491.2008.02434.x ◽

2008 ◽

Vol 25 (5) ◽

pp. 550-556 ◽

Cited By ~ 5

Author(s):

M. S. Roy ◽

B. Peng

Keyword(s):

Risk Factors ◽

African Americans ◽

Lower Extremity ◽

Arterial Disease ◽

Lower Extremity Arterial Disease ◽

Associated Risk Factors

Download Full-text

Lessons learned from the analysis of gender effect on risk factors and procedural outcomes of lower extremity arterial disease

Journal of Vascular Surgery ◽

10.1016/j.jvs.2010.05.106 ◽

2010 ◽

Vol 52 (5) ◽

pp. 1196-1202 ◽

Cited By ~ 64

Author(s):

Ageliki G. Vouyouka ◽

Natalia N. Egorova ◽

Alexander Salloum ◽

Lawrence Kleinman ◽

Michael Marin ◽

...

Keyword(s):

Risk Factors ◽

Lower Extremity ◽

Arterial Disease ◽

Gender Effect ◽

Lessons Learned ◽

Lower Extremity Arterial Disease ◽

Procedural Outcomes

Download Full-text

Association of skeletal muscle and cardiovascular risk factors in patients with lower extremity arterial disease

Annals of Vascular Surgery ◽

10.1016/j.avsg.2021.08.037 ◽

2021 ◽

Author(s):

J. Ferreira ◽

A. Carneiro ◽

I. Vila ◽

C. Cunha ◽

C. Silva ◽

...

Keyword(s):

Risk Factors ◽

Skeletal Muscle ◽

Cardiovascular Risk ◽

Lower Extremity ◽

Cardiovascular Risk Factors ◽

Arterial Disease ◽

Lower Extremity Arterial Disease

Download Full-text

Body Fat Distribution, Cardiometabolic Traits, and Risk of Major Lower-Extremity Arterial Disease in Postmenopausal Women

10.2337/figshare.16775866 ◽

2021 ◽

Author(s):

Guo-Chong Chen ◽

Rhonda Arthur ◽

Victor Kamensky ◽

Jin Choul Chai ◽

Bing Yu ◽

...

Keyword(s):

Risk Factors ◽

Lower Extremity ◽

Postmenopausal Women ◽

Body Fat ◽

Positive Association ◽

Fat Distribution ◽

Arterial Disease ◽

Hip Circumference ◽

Lower Extremity Arterial Disease ◽

Cardiometabolic Traits

OBJECTIVE To assess the relationship between body fat distribution and incident lower-extremity arterial disease (LEAD). RESEARCH DESIGN AND METHODS We included 155,925 postmenopausal women with anthropometric measures from the Women’s Health Initiative who had no known LEAD at recruitment. A subset of 10,894 participants had body composition data quantified by dual energy X-ray absorptiometry (DXA). Incident cases of symptomatic LEAD were ascertained and adjudicated via medical record review. RESULTS We identified 1152 incident LEAD cases during a median 18.8 years follow-up. After multivariable adjustment and mutual adjustment, waist and hip circumference was positively and inversely associated with risk of LEAD, respectively (both P-trend values <0.0001). In a subset (n = 22,561) where various cardiometabolic biomarkers were quantified, a similar positive association of waist circumference with risk of LEAD was eliminated after adjustment for diabetes and HOMA-IR (P-trend = 0.89), whereas hip circumference remained inversely associated with the risk after adjustment for major cardiometabolic traits (P-trend = 0.0031). In the DXA subset, higher trunk fat (P-trend = 0.0081) and higher leg fat (P-trend <0.0001) was associated with higher and lower risk of LEAD, respectively. Further adjustment for diabetes, dyslipidemia, and blood pressure diminished the association for trunk fat (P-trend = 0.49), yet the inverse association for leg fat persisted (P-trend = 0.0082). CONCLUSIONS Among US postmenopausal women, a positive association of upper-body fat with risk of LEAD appeared to be attributable to traditional risk factors especially insulin resistance. Lower-body fat was inversely associated with risk of LEAD beyond known risk factors.

Download Full-text

Retraction Note: Association of severity of coronary artery disease by SYNTAX score (SS) and lower extremity arterial disease by duplex ultrasound (DUS) study—an Indian perspective

The Egyptian Heart Journal ◽

10.1186/s43044-020-00130-9 ◽

2020 ◽

Vol 72 (1) ◽

Author(s):

Saumen Nandi ◽

Anindya Mukherjee ◽

Dibbendhu Khanra ◽

Kaushik Biswas

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Lower Extremity ◽

Duplex Ultrasound ◽

Arterial Disease ◽

Syntax Score ◽

Lower Extremity Arterial Disease ◽

Retraction Notice ◽

Artery Disease ◽

Indian Perspective

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s43044-020-00091-z.

Download Full-text

Omega-3 Polyunsaturated Fatty Acid Supplementation in Patients with Lower Extremity Arterial Disease

Journal of the American College of Nutrition ◽

10.1080/07315724.2021.1891155 ◽

2021 ◽

pp. 1-9

Author(s):

Min-I Su ◽

Ying-Chih Cheng ◽

Yu-Chen Huang ◽

Cheng-Wei Liu

Keyword(s):

Fatty Acid ◽

Lower Extremity ◽

Polyunsaturated Fatty Acid ◽

Arterial Disease ◽

Omega 3 ◽

Lower Extremity Arterial Disease ◽

Fatty Acid Supplementation ◽

Acid Supplementation

Download Full-text

Diagnostic Performance of Ankle-Brachial Pressure Index in Lower Extremity Arterial Disease

The Surgery Journal ◽

10.1055/s-0041-1731444 ◽

2021 ◽

Vol 07 (03) ◽

pp. e132-e137

Author(s):

Mohammed Alagha ◽

Thomas M. Aherne ◽

Ahmed Hassanin ◽

Adeel S. Zafar ◽

Doireann P. Joyce ◽

...

Keyword(s):

Lower Extremity ◽

Sensitivity And Specificity ◽

False Negative ◽

Arterial Disease ◽

Initial Assessment ◽

Reference Standard ◽

Lower Extremity Arterial Disease ◽

Negative Results ◽

Positive Results ◽

Arterial Imaging

Abstract Introduction Ankle-brachial pressure indices (ABIs) continue to form the basis of diagnostics for lower extremity arterial disease (LEAD). However, there remains a paucity of data to support its accuracy. This study aims to evaluate its diagnostic sensitivity and specificity using established arterial-imaging modalities as a benchmark. Methods In this retrospective study, a regional, prospectively maintained, vascular laboratory database was interrogated to identify referred patients with arterial disease who underwent concomitant assessment with ABI and lower limb arterial duplex ultrasound (DUS). Duplex acted as the reference standard. Those who had peripheral computed tomography angiogram (CTA) within 3 months of initial assessment were included in a subgroup analysis to correlate ABI with CTA. The primary end point was the sensitivity and specificity of ABI compared with DUS as the reference standard. Results Concomitant assessment was performed in 438 limbs (250 patients) over a 27-month period. The ABI was normal (0.9 to 1.4) in 196 limbs (44.9%) and abnormal in the remaining 241 limbs (55.1%). False-positive results occurred in 83 out of 241 limbs (34.4%), and false-negative results occurred in 54 limbs out of 196 (27.5%). True-positive results were 158 out of 241 limbs (65.6%), whereas true-negative results were 142 out of 196 limbs (72.4%). ABI using DUS as a benchmark identified a sensitivity for peripheral artery disease of 72.3% and a specificity of 69.3%. Concomitant CTA imaging was available in 200 limbs. The sensitivity and specificity of ABI correlated with CTA were 65.5 and 68.8%, respectively. Conclusion ABIs have a moderate predictive value in the diagnosis of LEAD. Normal range outcomes cannot be taken to infer the absence of LEAD and, as such, further arterial imaging in the form of DUS or angiography should be strongly considered in those with suspected underlying disease requiring intervention. Further noninvasive tests such as exercise studies or pulse volume waveforms should be considered, if diagnostic uncertainty exists, in those requiring nonoperative intervention and risk factor control.

Download Full-text