Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes.

Abstract

BACKGROUND:

Little is known about the evolution of peripheral arterial disease (PAD) since diagnosis and its association with glycemic and lipid control in patients with Type 2 Diabetes Mellitus (T2DM).

OBJECTIVE:

Evaluate the actual criteria to start screening PAD with ankle-brachial index (ABI) in T2DM patients and assess its progression and relationship with glycemic and lipid control since diagnosis.

METHODS:

We performed a 3-year prospective cohort study with two groups: group 1 (978 individuals with T2DM undergoing drug treatment) and group 2 [221 newly diagnosed drug-naive (< 3 months) patients with T2DM]. PAD diagnosis was by ABI ≤ 0.90, regardless any symptoms.

RESULTS:

As expected, abnormal ABI prevalence was higher in group 1 vs. Group 2 (87% vs. 60%, p < 0.001). However, abnormal ABI prevalence did not differ between patients over and under 50 years in both groups. Our drug-naive group stabilizes ABI (0.9 ± 0.1 vs 0.9 ± 0.1, p = NS) and improved glycemic and lipid control during follow-up [glycated hemoglobin (HbA1c) = 8.9 ± 2.1 vs 8.4 ± 2.3%, p < 0.05; LDL = 132 ± 45 vs 113 ± 38 mg/dL, p < 0.01, respectively]. When compared, patients who evolved with normalization or maintained normal ABI levels at the end [Group A, N = 60 (42%)] with those who decreased ABI to abnormal levels (ABI basal 1.0 ± 0.1 vs final 0.85 ± 0.1, p < 0.001) [Group B, N = 26 (18%)], an improvement in HbA1c (9 ± 2 vs 8 ± 2%, p < 0.05) and a correlation between the final HbA1c with ABI (r = - 0.3, p = 0.01) was found only in the first. In addition, a correlation was found between albuminuria variation and ABI solely in group A (r = - 0.3; p < 0.05).

CONCLUSION:

Our study suggests that ABI should be measured at diagnosis in T2DM patients, indicating that current criteria to select patients to screen PAD with ABI must be simplified. An improvement in albuminuria and glycemic and lipid control could be related with ABI normalization in newly diagnosed T2DM drug-naive patients.

• Authors: João Soares Felício, Franciane Trindade Cunha de Melo, Giovana Miranda Vieira, Vitória Teixeira de Aquino, Fernanda de Souza Parente, Wanderson Maia da Silva, Nivin Mazen Said, Emanuele Rocha da Silva, Ana Carolina Contente Braga de Souza, Maria Clara Neres Iunes de Oliveira, Gabriela Nascimento de Lemos, Ícaro José Araújo de Souza, Angélica Leite de Alcântara, Lorena Vilhena de Moraes, João Felício Abrahão Neto, Natércia Neves Marques de Queiroz, Neyla Arroyo Lara Mourão, Pedro Paulo Freire Piani, Melissa de Sá Oliveira Dos Reis, Karem Mileo Felício
• Journal: BMC cardiovascular disorders (BMC Cardiovasc Disord) Vol. 22 Issue 1 Pg. 294 (06 27 2022) ISSN: 1471-2261 [Electronic] England
• PMID: 35761179 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Lipids

Topics

• Albuminuria
• Ankle Brachial Index
• Blood Glucose
• Cohort Studies
• Diabetes Mellitus, Type 2 (diagnosis, drug therapy, epidemiology)
• Glycated Hemoglobin
• Humans
• Lipids
• Peripheral Arterial Disease (diagnosis, epidemiology)
• Prospective Studies
• Risk Factors