An Evaluation of Biomarkers as Determinants of Peripheral Arterial Disease in those with Diabetes Mellitus

Abstract

Peripheral arterial disease (PAD) is characterized by reduced arterial perfusion in lower limb extremities due to atherosclerosis. The disease is mostly asymptomatic with poor diagnosis and prognosis, usually co‐existing with other diseases. Its burden is rising globally, especially among diabetics; consequently increasing the risk of vascular damage, lower limb amputation, and cardiovascular disorders. Therefore, it is essential to identify biomarkers for in‐time diagnosis and efficient prognosis of diabetes‐associated PAD. In this study, several markers were evaluated that can identify PAD development in diabetics. These biomarkers include blood urea nitrogen (BUN), serum creatinine, creatine kinase‐MB (CK‐MB), prothrombin time (PT), activated partial thrombopalstin time (aPTT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glycated hemoglobin (HbA1c), total cholesterol, triglycerides, low‐density lipoproteins (LDL), high density lipoproteins (HDL) and C reactive protein (CRP). All these markers were analyzed in blood samples using standard methods and results were interpreted by comparing them with widely accepted cut‐off values. After all experimental procedures, it was found that levels of AST (35.04 U/L), ALT (37.21 U/L), BUN (37.93 mg/dL), CK‐MB (22.01 IU/L), HbA1c (8.79 %), triglycerides (297.65 mg/dL), total cholesterol (234.59 mg/dL) and CRP (5.48 mg/L) were significantly higher in diabetic patients having PAD while slight increase was observed in coagulation profile (PT (14.27 s), aPTT (35.15 s) and INR (1.15), in diabetics plus PAD as compared to diabetics alone. However, it has been observed that levels of HDL were reduced in both diabetics (41.14 mg/dL) and diabetics plus PAD (43.54) as compared to control (healthy individuals) results (53.67) while LDL levels were increased in diabetics (117.42 mg/dL) and diabetics plus PAD (122.22) as compared to healthy individuals (102.76). Therefore, it was concluded that AST, ALT, urea, cholesterol, triglycerides, HDL, LDL, CK‐MB and CRP can serve as diagnostic and prognostic biomarkers in diabetics having PAD to improve life of patients.