Association of Circulating Osteopontin Levels With Lower Extremity Arterial Disease in Subjects With Type 2 Diabetes Mellitus: A Cross-Sectional Observational Study

2020 ◽  
Vol 19 (2) ◽  
pp. 180-189
Author(s):  
Ioanna Eleftheriadou ◽  
Dimitrios Tsilingiris ◽  
Anastasios Tentolouris ◽  
Iordanis Mourouzis ◽  
Pinelopi Grigoropoulou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lower Extremity ◽  
Geometric Mean ◽  
Multivariable Analysis ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Lower Extremity Arterial Disease

Osteopontin (OPN) is involved in the atherosclerotic and inflammatory process. In this article, we examined the relationship between circulating OPN levels with lower extremity arterial disease (LEAD) in individuals with type 2 diabetes mellitus (T2DM). Seventy individuals with T2DM and 66 individuals without T2DM were recruited. Diagnosis of LEAD was based on the absence of triphasic waveform on the pedal arteries. Plasma OPN levels were determined by Luminex Multiplex immunoassay. LEAD was present in 34 (48.6%) patients with T2DM. In the diabetes cohort, individuals with LEAD had higher plasma OPN concentrations than those without LEAD (geometric mean [95% confidence intervals]; 43.4 [37.5-50.4] vs 26.1 [22.9-29.8] ng/mL, respectively, P < .001). Multivariable analysis showed that presence of LEAD independently associated with higher OPN levels in subjects with T2DM, with marginal statistical significance ( P = .049). In both cohorts, plasma OPN concentrations were negatively associated with ankle-brachial index values ( P < .05). In the total sample, there was a gradual increase of OPN levels across subgroups with triphasic, biphasic, and monophasic/blunted waveforms ( P < .001). In conclusion, plasma OPN levels are associated with the presence and severity of LEAD in subjects with T2DM. Further studies are needed to investigate the role of OPN in the pathogenesis and progression of LEAD.

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

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.

scholarly journals Efficacy and Safety of Adjunctive Cilostazol to Clopidogrel‐Treated Diabetic Patients With Symptomatic Lower Extremity Artery Disease in the Prevention of Ischemic Vascular Events

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kallirroi Kalantzi ◽  
Nikolaos Tentolouris ◽  
Andreas J. Melidonis ◽  
Styliani Papadaki ◽  
Michail Peroulis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lower Extremity ◽  
Arterial Disease ◽  
Efficacy And Safety ◽  
Vascular Events ◽  
Lower Extremity Arterial Disease ◽  
Ischemic Attack

Background Type 2 diabetes mellitus is a risk factor for lower extremity arterial disease. Cilostazol expresses antiplatelet, anti‐inflammatory, and vasodilator actions and improves the claudication intermittent symptoms. We investigated the efficacy and safety of adjunctive cilostazol to clopidogrel‐treated patients with type 2 diabetes mellitus exhibiting symptomatic lower extremity arterial disease, in the prevention of ischemic vascular events and improvement of the claudication intermittent symptoms. Methods and Results In a prospective 2‐arm, multicenter, open‐label, phase 4 trial, patients with type 2 diabetes mellitus with intermittent claudication receiving clopidogrel (75 mg/d) for at least 6 months, were randomly assigned in a 1:1 ratio, either to continue to clopidogrel monotherapy, without receiving placebo cilostazol (391 patients), or to additionally receive cilostazol, 100 mg twice/day (403 patients). The median duration of follow‐up was 27 months. The primary efficacy end point, the composite of acute ischemic stroke/transient ischemic attack, acute myocardial infarction, and death from vascular causes, was significantly reduced in patients receiving adjunctive cilostazol compared with the clopidogrel monotherapy group (sex‐adjusted hazard ratio [HR], 0.468; 95% CI, 0.252–0.870; P =0.016). Adjunctive cilostazol also significantly reduced the stroke/transient ischemic attack events (sex‐adjusted HR, 0.38; 95% CI, 0.15–0.98; P =0.046) and improved the ankle‐brachial index and pain‐free walking distance values ( P =0.001 for both comparisons). No significant difference in the bleeding events, as defined by Bleeding Academic Research Consortium criteria, was found between the 2 groups (sex‐adjusted HR, 1.080; 95% CI, 0.579–2.015; P =0.809). Conclusions Adjunctive cilostazol to clopidogrel‐treated patients with type 2 diabetes mellitus with symptomatic lower extremity arterial disease may lower the risk of ischemic events and improve intermittent claudication symptoms, without increasing the bleeding risk, compared with clopidogrel monotherapy. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02983214.

Lower extremity artery disease in patients with type 2 diabetes

2019 ◽  
Vol 26 (2_suppl) ◽  
pp. 114-124 ◽  
Author(s):  
Giacomo Buso ◽  
Victor Aboyans ◽  
Lucia Mazzolai
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Lower Extremity ◽  
Arterial Disease ◽  
Lipid Lowering ◽  
Current Evidence ◽  
Lower Extremity Arterial Disease

Among all peripheral arterial diseases, lower extremity arterial disease is a serious condition in subjects with type 2 diabetes mellitus, associated with important disability, cardiovascular risk, and socio-economic burden. Patients with both conditions generally display poorer prognosis of affected limbs compared with non-diabetic subjects, leading to increased rates of adverse limb events including amputations. Nonetheless, awareness on lower extremity arterial disease remains somehow suboptimal in the diabetic population, partly related to an atypical clinical presentation in several cases. A regular and appropriate screening for lower extremity arterial disease in patients suffering from type 2 diabetes mellitus is therefore recommended. Affected subjects should receive optimal medical treatment including careful management of the different cardiovascular risk factors through a healthy lifestyle, a regular and structured physical activity, the administration of lipid-lowering, antidiabetic drugs, and (when indicated) antihypertensive and antithrombotic drugs. This review aims to outline current evidence about lower extremity arterial disease in patients with type 2 diabetes mellitus, in order to elucidate its epidemiology, pathophysiology, screening and diagnosis, and management options.

scholarly journals Penyakit Arteri Perifer dan Mortalitas Kardiovaskular pada Pasien Diabetes Melitus Tipe-2

2019 ◽  
Vol 6 (2) ◽  
pp. 100
Author(s):  
Em Yunir ◽  
Dekta Filantropi Esa ◽  
Adelia Nova Prahasary ◽  
Dicky Levenus Tahapary
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Arterial Disease ◽  
Cardiovascular Mortality ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Peripheral Arterial ◽  
Diabetes Melitus

Peripheral arterial disease (PAD) merupakan salah satu komplikasi makrovaskular diabetes melitus tipe 2 (DMT2) yang dikaitkan dengan peningkatan risiko mortalitas kardiovaskular. Pemeriksaan ankle-brachial index (ABI) merupakan salah satu pemeriksaan yang sederhana dan mudah dilakukan untuk menegakkan diagnosis PAD. Oleh karena itu, penulis ingin mengetahui tingkat mortalitas kardiovaskular pasien DMT2 dengan PAD. Dari hasil penelusuran literatur, didapatkan tujuh literatur. Studi Bundo dkk melaporkan hasil HR 2,45 (interval kepercayaan [IK] 95%: 0,84-7,17). Studi Mostaza dkk melaporkan hasil HR 1,64 (IK 95%: 0,64-4,49). Studi Aboyans dkk melaporkan hasil HR 2,21 (IK 95%: 1,16-4,22). Studi Mohammedi dkk melaporkan hasil HR 1,35 (IK 95%: 1,15-1,60). Studi Quiles dkk melaporkan hasil HR 6,61 (IK 95%: 2,47-17,72). Studi Mueller dkk melaporkan hasil  RR 3,53 (IK 95%: 1,80-6,91). Studi lanjutan Mueller dkk melaporkan hasil  RR 4,06 (IK 95%: 2,67-6,18). Dari hasil studi tersebut, dapat disimpulkan bahwa pasien DMT2 yang disertai dengan PAD akan meningkatkan mortalitas kardiovaskular, serta nilai ABI dapat digunakan sebagai instrumen stratifikasi independen mortalitas kardiovaskularKata Kunci:Ankle brachial index, diabetes melitus tipe 2, mortalitas kardiovaskular, penyakit arteri perifer Peripheral Arterial disease and Cardiovascular Mortality in Type-2 Diabetes MellitusPeripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM), which increases the risk of cardiovascular mortality. Ankle-brachial index (ABI) is one of the simple and widely available tool to diagnose PAD. The authors aim to find out the cardiovascular mortality in T2DM patient with PAD. Bundo et al. study found HR 2.45 (95% CI: 0.84 to 7.17). Mostaza et al. study reported HR 1.64 (95% CI: 0.64 to 4.49). Aboyans et al. study declared HR 2.21 (95% CI: 1.16 to 4.22). Mohammedi K et al. claimed HR 1.35 (95% CI: 1.15 to 1.60). Quiles et al. found HR 6.61 (95% CI: 2.47 to 17.72). Mueller et al. study reported  RR 3,53 (95% CI: 1.80 to 6.91). Mueller et al. study reported  RR 4,06 ( 95% CI: 2.67 to 6.18).  In conclusion, the mortality risk in T2DM patients with PAD is higher compared to those without PAD. Moreover, an ankle-brachial index can be used as an independent stratification tool to predict the risk of cardiovascular mortality

scholarly journals EFFECT OF LEG EXERCISE ON THE ANKLE BRACHIAL INDEX (ABI) OF TYPE 2 DIABETES MELLITUS PATIENTS IN REJANG LEBONG REGIONAL HOSPITAL

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Derison Marsinova Bakara ◽  
Kurniyati Kurniyati
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Arterial Disease ◽  
Exercise Intervention ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Wilcoxon Test ◽  
Peripheral Arterial

Introduction: Peripheral arterial disease often occurs in patients with type 2 diabetes mellitus. Peripheral arterial disease in patients with type 2 diabetes mellitus occurs due to decreased blood circulation in the lower extremities. Looking at the value of the ankle-brachial index is one of the actions that can be taken to detect peripheral arterial disease. Objective: The purpose of this study was to determine the effect of a foot exercise intervention on the ankle-brachial index value of type 2 diabetes mellitus patients. Methods: This research was a quantitative research with a pre-experimental design, with one pre-test and post-test design. The research was carried out at Rejang Lebong Hospital from August to November 2020. The number of samples used in this study were 35 patients experiencing type 2 diabetes mellitus for more than five years. The analysis used in this study was the Wilcoxon test. Results: The results showed a difference in the mean of the ankle-brachial index before (1.02) and after (1.12) the intervention. Thus, there was an increase of 0.10 in the average value of the ankle-brachial index. The analysis result of this study showed the value of p = 0.001 (p<0.05). Conclusion: Foot exercise can be used as an alternative intervention to increase the value of the ankle-brachial index in patients with type 2 diabetes mellitus.

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