Prevalence of peripheral vascular disease and its association with carotid intima-media thickness and arterial stiffness in type 2 diabetes: The Chennai Urban Rural Epidemiology Study (CURES 111)

Pradeepa, Rajendra; Chella, S; Surendar, Jayagopi; Indulekha, Karunakaran; Mohan, Viswanathan

doi:10.1177/1479164114524584

Cited by 39 publications

(24 citation statements)

References 52 publications

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“…28 In a prospective cohort of 145 PAD patients, Pradeepa et al found an association between augmentation index and PAD, but this association was lost when adjusting for age. 29 Finally, Beckmann et al demonstrated a higher central AIX in abdominal aortic aneurysm and PAD patients compared to healthy controls, but their control group was significantly younger and healthier than controls in the present study, which also included patients with aneurysmal disease. 17 Overall, the present study adds to the literature by demonstrating in one of the largest samples an independent association between AIX and PAD.…”

Section: Discussioncontrasting

confidence: 56%

Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry

Zahner

Gruendl

Spaulding

et al. 2017

Journal of Vascular Surgery

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Objective Arterial stiffness and peripheral artery disease (PAD) are both associated with an elevated risk of major adverse cardiac events (MACE); however, the association between arterial stiffness and PAD is less well characterized. The goal of the present study was to examine the association between parameters of radial artery tonometry, a non-invasive measure of arterial stiffness, and PAD. Methods We conducted a cross-sectional study of 134 vascular surgery outpatients (controls=33, PAD=101) using arterial applanation tonometry. Central augmentation index normalized to 75bpm (central AIX) and peripheral augmentation index (peripheral AIX) were measured using radial artery pulse wave analysis (PWA). Pulse wave velocity (PWV) was recorded at the carotid and femoral arteries. PAD was defined as symptomatic claudication with an ankle-brachial index (ABI) of <0.9 or a history of peripheral revascularization. Controls had no history of atherosclerotic vascular disease and an ABI≥0.9. Results Among the 126 participants with high quality tonometry data, compared to controls (n=33), patients with PAD (n=93) were older, with higher rates of hypertension, hyperlipidemia, diabetes, and smoking (P<.05). Patients with PAD also had greater arterial stiffness as measured by central AIX, peripheral AIX, and PWV (P<.05). In a multivariable model, each 10-unit increase in central and peripheral AIX was associated with significantly increased odds of PAD (OR 2.1, 95% CI 1.1–3.9, P=.03 and OR 1.9, 95% CI 1.2–3.2, P=.01, respectively). Additionally, central and peripheral AIX were highly correlated (r(120)=.76, P<.001). Conclusions In a cross-sectional analysis, arterial stiffness as measured by the augmentation index is independently associated with PAD, even when adjusting for several atherosclerotic risk factors. Further prospective data is needed to establish whether radial artery tonometry could be a tool for risk stratification in the PAD population.

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Section: Discussioncontrasting

confidence: 56%

Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry

Zahner

Gruendl

Spaulding

et al. 2017

Journal of Vascular Surgery

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“…Although there are inconsistencies among studies regarding the risk factors, PAD is a major risk factor for LEA, in agreement with our results ( P = 0·001, OR = 9·07). PAD is commonly seen in individuals with type 2 diabetes, in whom it occurs almost threefold more frequently compared with age‐ and sex‐matched non‐diabetic individuals .…”

Section: Discussionmentioning

confidence: 99%

Comparison of five systems of classification of diabetic foot ulcers and predictive factors for amputation

Jeon

Choi

Kang

et al. 2016

International Wound Journal

112

120

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Diabetes mellitus is a common metabolic disorder. Among various complications, diabetic neuropathy and peripheral vascular disorders are closely associated with diabetic foot ulcers (DFUs). Lower extremity ulcers and amputations are ongoing problems among individuals with diabetes. There are several classification systems for DFUs; however, no prognostic system has to date been accepted as the gold standard or the optimum prediction tool for amputations. A retrospective study was designed. Demographic data and baseline laboratory data were gathered and scored or evaluated using five representative DFU classification systems. These included (i) the diabetic ulcer severity score (DUSS); (ii) University of Texas (UT) diabetic wound classification; (iii) Meggitt-Wagner classification; (iv) depth of the ulcer, extent of bacterial colonisation, phase of ulcer and association aetiology (DEPA) scoring system; and (v) site, ischaemia, neuropathy, bacterial infection and depth (SINBAD) score. Finally, a statistical analysis was performed. A total of 137 patients were included in this study. During the follow-up, DFU had healed in 51·1% of subjects and 48·9% of the individuals underwent lower extremity amputations (LEAs). In a univariable logistic regression analysis, history of previous DFU, hypertension, neuropathy, haemoglobin, C-reactive protein (CRP) and ankle-brachial index (ABI) showed a statistically significant difference between the healed group and the LEA group. Moreover, the stages, grades or overall prognostic ability of all five classifications were highly associated with the overall occurrence of LEA. On multivariable logistic regression analysis of the risk of LEA, all classifications showed a significant positive trend with an increased number of amputations. All the five classification systems exhibited high sensitivity, specificity, classification accuracy, positive predictive, negative predictive and area under the curve (AUC) values. They showed substantial accuracy and their main variables were associated with LEA occurrence. The Wagner and UT systems, although they are relatively simple to assess, were better predictors of LEA.

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“…Available data also suggest that the susceptibility of Asian Indians to the complications of diabetes mellitus differs from that of the Western population [36][37][38][39] . The vascular complications of T2DM account for the majority of the social and economic burden.…”

Section: Burden Of Diabetesmentioning

confidence: 99%

Built Environment, Physical Activity and Diabetes

Anjana

2017

Current Science

Self Cite

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Type-2 diabetes, which has emerged as a global epidemic in recent years, is strongly related to lifestyle and economic change. The built environment (BE) influences lifestyle factors such as physical activity and diet. Evidence shows that individuals who live in neighbourhoods with the availability of destinations for physical activity within walking/cycling distance are more likely to engage in the same and thereby improve their health. Walking can be increased in neighbourhoods by providing useable and unencroached pedestrian pathways, undertaking motor-traffic reduction strategies, improved perceived neighbourhood safety, increasing good street connectivity, parks, green space, playgrounds and recreation areas. Thus for the BE to positively influence health outcomes and be made more activity-friendly, requires combined efforts of health professionals and stakeholders in the Government as well as the private sector.

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Prevalence of peripheral vascular disease and its association with carotid intima-media thickness and arterial stiffness in type 2 diabetes: The Chennai Urban Rural Epidemiology Study (CURES 111)

Cited by 39 publications

References 52 publications

Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry

Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry

Comparison of five systems of classification of diabetic foot ulcers and predictive factors for amputation

Built Environment, Physical Activity and Diabetes

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