Peripheral arterial disease in relation to glycaemic level in an elderly Caucasian population: the Hoorn Study

Abstract

We investigated the cross-sectional association between peripheral arterial disease and glycaemic level in an age, sex, and glucose tolerance stratified random sample from a 50-74-year-old Caucasian population. Subjects treated with oral hypoglycaemic agents or insulin were classified as having known diabetes mellitus (KDM) (n = 67). Using two oral glucose tolerance tests, and based on World Health Organisation criteria, all other participants were categorized as having a normal (NGT) (n = 288), an impaired (IGT) (n = 170), or a diabetic (NDM) (n = 106) glucose tolerance. Prevalence rates of ankle-brachial pressure index less than 0.90 were 7.0%, 9.5%, 15.1% and 20.9% in NGT, IGT, NDM and KDM subjects, respectively (chi-square test for linear trend: p < 0.01). Prevalence rates of any peripheral arterial disease (ankle-brachial pressure index < 0.90, at least one monophasic or absent Doppler flow curve or vascular surgery) were 18.1%, 22.4%, 29.2% and 41.8% in these categories (chi-square test for linear trend: p < 0.0001). The prevalence of any peripheral arterial disease was higher in KDM and NDM than in NGT (p < 0.03, p < 0.0001, respectively), whereas no statistically significant difference was demonstrated between IGT and NGT. The same applied when using the ankle-brachial pressure index criterion. Logistic regression analyses showed that any arterial disease was significantly associated with HbA1c, fasting and 2-h post-load plasma glucose after correction for cardiovascular risk factors (odds ratios and 95% confidence intervals 1.35; 1.10-1.65 per %, 1.20; 1.06-1.36 and 1.06; 1.01-1.12 per mmol/l, respectively), whereas it was not associated with fasting and 2-h post-load specific insulin. Ankle-brachial pressure indices were not associated with either plasma glucose parameters or insulin in univariate or multivariate analyses. In conclusion, parameters of glucose tolerance are independently associated with any peripheral arterial disease, whereas insulin is not.

Measures of cardiovascular autonomic nervous function: agreement, reproducibility, and reference values in middle age and elderly subjects

“…Study is a prospective study of glucose tolerance and cardiovascular risk factors in a 50 to 75-year-old general Caucasian population [35,36,37,38]. In short, an age-, sex-and glucosetolerance-stratified sample of 708 subjects out of a cohort of 2484 was invited for a second 75-gram oral glucose tolerance test within 3 to 5 weeks and requested to undergo an extensive physical examination, including autonomic function tests, on another day.…”

Microalbuminuria and Peripheral Arterial Disease Are Independent Predictors of Cardiovascular and All-Cause Mortality, Especially Among Hypertensive Subjects

“…19 In brief, 2484 white subjects (71% of those invited) participated. All subjects, except previously diagnosed diabetic subjects treated with oral glucoselowering agents or insulin, underwent an oral glucose tolerance test (OGTT) according to the WHO guidelines.…”

“…The prevalences of NGT, IGT, and NIDDM, and of associated variables, such as microalbuminuria, in the present study population are not the same as in the initial cohort, but because the exact sampling procedure is known, we can back-calculate the prevalences in the initial cohort (nϭ2484) from those in the second sample (nϭ631), as previously described in detail. 19,21 From these subjects, we obtained an ankle-brachial blood pressure index (ABPI) (nϭ631), a resting ECG (ECG) (nϭ625), and an early-morning, first-voided spot urine sample to measure the urinary albumin-to-creatinine ratio (ACR) (nϭ607). Urinary albumin was measured by rate nephelometry (Array Protein System, Beckman) with a threshold of 6.2 mg/L and intra-and interassay coefficients of variation of Յ5% and Յ8%, respectively.…”

“…26 Data on weight, height, body mass index (BMI), smoking habits, glycated hemoglobin (HbA1c), fasting specific plasma insulin, fasting serum creatinine, total cholesterol, HDL-cholesterol, and triglyceride levels were obtained. 19,21 Low density lipoprotein-cholesterol was calculated by the Friedewald formula, 27 except when triglyceride level was Ͼ4.55 mmol/L (nϭ23). The creatinine clearance was calculated from serum creatinine using the Cockcroft and Gault formula.…”

Quality of life and burden of disease in peripheral arterial disease: a study among Hungarian patients

“…A dohányzás 2-6-szorosára [3,4,5,6], a diabetes mellitus 2-4-szeresére [7,8] növeli a betegség kialakulásának valószínűségét. A betegség következtében megnő az alsó végtagi major amputáció kockázata, az egyidejűleg fennálló diabetes mellitus megléte 7-15-szö-rösére nö veli ezt a kockázatot [9].…”