Peripheral arterial disease and its correlates in patients with type 2 diabetes mellitus in a teaching hospital in northern Nigeria: a cross-sectional study

Abstract

Background: Peripheral arterial disease (PAD) is a risk factor for diabetic foot ulcer, limb amputation as well as coronary heart disease. It is more common in patients with diabetes mellitus (DM) and co-exists with peripheral neuropathy. Prevalence of PAD in type 2 DM patients in northern Nigeria is largely unknown. We investigated the occurrence and factors associated with PAD among patients with type 2 DM in a tertiary hospital in northern Nigeria. Methods: This was a cross-sectional analytic study. We recruited 200 patients with type 2 DM consecutively from the diabetes clinic of the Jos University Teaching Hospital. Ankle brachial index was assessed for each participant. Clinical information, anthropometric indices and blood samples were collected for assay. Data was analysed using CDC Epi-Info and logistic regression analysis was used to determine independent correlates of PAD. RESULTS:PAD was present in 38.5%(n = 77) of subjects and it was associated with the female sex, age ≥ 50 years, Body mass index (BMI) ≥ 25 kg/m 2 and low HDL cholesterol levels. However, on multiple logistic regression, a BMI ≥ 25 kg/m 2 and a low HDL cholesterol level were independent correlates of PAD(adjusted OR = 2.13,95% CI = 1.04-4.36 and adjusted OR = 2.31, 95% CI = 1.04-5.15, respectively). Conclusion: PAD is present in more than a third of patients with type 2 DM in a tertiary hospital in northern Nigeria. A BMI of ≥25 kg/m 2 and low HDL cholesterol levels were independent correlates of PAD.

Ankle Brachial Index Screening for Peripheral Arterial Disease in Asymptomatic Diabetic Patients

“…This study showed that there was no significant difference between both groups regarding hypertension may be because the majority were wellcontrolled by anti-hypertensive drugs. This study agrees with Agboghoroma et al (13) who showed that there was no significant difference between studied groups regarding hypertension. Against this study, Ghosh et al (11) and Shou et al (18) showed that hypertension was a significant risk factor for PAD in diabetics because elevated blood pressure leads to hardening of the blood vessels, which is known as atherosclerosis that results in development of PAD.…”

“…This agrees with Aljarid et al (10) , Ghosh et al (11) and Weledji et al (12) who showed that increasing age was a significant risk factor for PAD in diabetic patients. Against this study, Agboghoroma et al (13) showed that there was no significant difference between the two groups regarding age.…”

“…This agrees with Shaikh et al (9) and Ghosh et al (11) who showed that there was male predominance in asymptomatic diabetic patients with PAD. Against this study, Agboghoroma et al (13) showed that there was female predominance due to associated high BMI and total cholesterol levels. Furthermore, Weledji et al (12) showed that there was no significant difference between both groups regarding gender.…”

“…In addition, it agrees with Felício et al (14) regarding that the duration of DM was a risk for PAD in diabetic patients with or without symptoms for PAD. In contrary, Shaikh et al (9) and Agboghoroma et al (13) showed that no significant difference between both groups regarding DM duration.…”

Asymptomatic Cardiovascular Disorders in a Cohort of Clinically Stable Type 2 Diabetes Mellitus Patients in South Eastern Nigeria: A Cross Sectional Study

“…This was an unexpected finding, as hyperglycemia is a known risk factor for PAD. A few studies have also reported no significant correlations between HbA1c and PAD [28,29]. However, a single measurement of HbA1c being a snapshot of glycaemia over a period of 2-3 months may not capture the glycaemic state of the patient over a longer period, which would more accurately predict the risk of developing PAD, which is a chronic complication of diabetes.…”