DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191675

A study of prevalence of peripheral arterial disease in type 2 diabetes mellitus using ankle-brachial index and its correlation with coronary artery disease and its risk factors

R. K. Sharma, Pashaura S. Sandhu, Ajay Chhabra, Jagbir Singh, Rajat Kharbanda

Abstract


Background: Peripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM). There is significant difference in the reported prevalence of PAD and its associated risk factors between Indian and Western studies. The purpose of this study was to examine the PAD complicating T2DM, in particular the influence of PAD on the risk of CAD.

Methods: Randomly selected 100 T2DM patients presented to Guru Nanak Dev hospital were included. In addition to a detailed history and physical examination, anthropometric parameters like body mass index was measured. CAD in patients was diagnosed by a history of angina, ECG changes, any past history of CAD or any treatment taken for CAD. Ankle brachial index (ABI) was measured. Data was collected systematically and analyzed according to the standard statistical methods.

Results: The prevalence of PAD was 15%. CAD was present in 31%. PAD was found to be significantly correlated with age, duration of diabetes, smoking, systolic blood pressure, diastolic blood pressure, prevalence of BMI >25 kg/m2, HbA1c and serum HDL ≤40 mg%. Old age, high HbA1c level, and dyslipidaemia were found to be significant independent predictors of CAD.

Conclusions: Using ABI authors found evidence of PAD in 15% patients of T2DM. The prevalence of CAD was higher in patients with PAD. So, there is definite and strong correlation between PAD and CAD. Thus, the early diagnosis of PAD should alert the clinician to a high probability of underlying CAD.


Keywords


Ankle-brachial index, Coronary artery disease, Diabetes mellitus, Peripheral artery disease

Full Text:

PDF

References


Sheehan P. Peripheral arterial disease in people with diabetes: consensus statement recommends screening. Clinic Diab. 2004;22(4):179-80.

Elhadd TA, Robb R, Jung RT, Stonebridge PA, Belch JJ. Pilot study of prevalence of asymptomatic peripheral arterial occlusive disease in patients with diabetes attending a hospital clinic. Pract Diab Int. 1999;16(6):163-6.

Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA. 2001;286(11):1317-24.

Beks PJ, Mackaay AJ, De Neeling JN, De Vries H, Bouter LM, Heine RJ. Peripheral arterial disease in relation to glycaemic level in an elderly Caucasian population: the Hoorn study. Diabetol. 1995;38(1):86-96.

Zinman B, Gerich J, Buse JB, Lewin A, Schwartz S, Raskin P et al. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2010;33(3):692.

Janka HU, Standl E, Mehnert H. Peripheral vascular disease in diabetes mellitus and its relation to cardiovascular risk factors: screening with the Doppler ultrasonic technique. Diabet Care. 1980;3(2):207-13.

Agrawal RP, Ranka M, Beniwal R, Sharma S, Purohit VP, Kochar DK, et al. Prevalence of micro and macro vascular complications in type 2 diabetes and their risk factors. Age. 2004;50:12-4.

Madhu SV, Kant S. Preclinical evaluation of atherosclerosis. Int J Diab Develop Countries. 2006;26(3).

Kumar S, Gupta A, Aswal V, Barala PD. Prevalence of asymptomatic peripheral vascular disease among type 2 diabetes mellitus patients. Int J Cur Res Rev. 2017;9(10):49-52.

Kumar A, Kumar A, Kumar H, Jha HK, Nayak S, Roy C. Prevalence of peripheral arterial disease & associated risk factors among type 2 diabetes mellitus patients attending diabetic health camp. Prevalence. 2018;3(2).

Mohan V, Premalatha G, Sastry NG. Peripheral vascular disease in non-insulin dependent diabetes mellitus in South India. Diabetes Res Clin Pract. 1995;27:235-40.

Premalatha G, Shanthirani S, Deepa R, Markovitz J, Mohan V. Prevalence and risk factors of peripheral vascular disease in a selected South Indian population: the Chennai urban population study. Diab Care. 2000;23(9):1295-300.

Norman PE, Davis WA, Bruce DG, Davis TM. Peripheral arterial disease and risk of cardiac death in type 2 diabetes: the Fremantle diabetes study. Diab Care. 2006;29(3):575-80.

Agrawal RP, Ranka M, Beniwal R, Sharma S, Purohit VP, Kochar DK, et al. Prevalence of micro and macro vascular complications in type 2 diabetes and their risk factors. Age. 2004;50:12-4.

Walters DP, Gatling W, Mullee MA, Hill RD. The prevalence, detection, and epidemiological correlates of peripheral vascular disease: a comparison of diabetic and non‐diabetic subjects in an English community. Diab Med. 1992;9(8):710-5.

Agarwal AK, Singh M, Arya V, Garg U, Singh VP, Jain V. Prevalence of peripheral arterial disease in type 2 diabetes mellitus and its correlation with coronary artery disease and its risk factors. J Assoc Physic India. 2012;60(7):28-32.

Belli B, Golabhavi N, Durgi C. Prevalence of peripheral arterial disease in type-2 diabetes mellitus and its correlation with coronary artery disease using ankle-brachial index. J Evol Med Dental Sci. 2015;4(11):1797-805.