The Basle Longitudinal Study: Report on the relation of initial glucose level to baseline ECG abnormalities, peripheral artery disease, and subsequent mortality

Silva, Alice Da; Widmer, Lea; Ziegler, H; Nissen, Catrine; Schweizer, W

doi:10.1016/0021-9681(79)90059-6

Cited by 64 publications

(23 citation statements)

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“…The absence of statistically significant differences in PAD prevalences between IGT and NGT subjects conforms with the results of three other studies [16,18,36], but seems to contradict the results of a further two studies [17,37]. However, in the first study the difference was not statistically significant [17], and in the second one the definition of 'IGT' did not conform with the World Health Organisation criteria [36]. It may be assumed that IGT subjects have been exposed to the milder hyperglycaemia for much shorter periods of time than diabetic subjects.…”

Section: Discussionsupporting

confidence: 90%

“…The Hoorn Study prevalence data were similar to those of a study among second generation Japanese-American men [17], and of an Italian study [16]. The absence of statistically significant differences in PAD prevalences between IGT and NGT subjects conforms with the results of three other studies [16,18,36], but seems to contradict the results of a further two studies [17,37]. However, in the first study the difference was not statistically significant [17], and in the second one the definition of 'IGT' did not conform with the World Health Organisation criteria [36].…”

Section: Discussionsupporting

confidence: 89%

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

et al. 1995

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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.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 89%

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

et al. 1995

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“…Numerous studies have demonstrated an association between diabetes mellitus and atherosclerosis, which can be detected early after the onset of the diabetes [16] and results in premature cardiovascular events and mortality. It is strongly linked to the development of PAD [15,17–19]. In one study, almost 25% of patients undergoing lower extremity revascularization were diabetic [17].…”

Section: Risk Factors For Padmentioning

confidence: 99%

Metabolic, endocrine and haemodynamic risk factors in the patient with peripheral arterial disease

Belch

2002

Diabetes Obesity Metabolism

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The morbidity and mortality associated with peripheral arterial disease (PAD) creates a huge burden in terms of costs both to the patient and to the health service. PAD is a deleterious and progressive condition that causes a marked increase in the risk of cardiovascular and cerebrovascular events. Further, PAD has a major negative impact on quality of life and mortality, and is associated with an increased risk of limb amputation. The clinical profile of patients at risk of PAD overlaps considerably with the known cardiovascular risk factors. These include, increasing age, smoking habit, diabetes, hypertension, dyslipidaemia, male sex and hyperhomocysteinaemia. For women, hormone replacement therapy appears to be associated with a reduced risk of PAD. Published PAD guidelines recommend aggressive management of risk factors, stressing the importance of lifestyle modification, antiplatelet agents, treating dyslipidaemia and diabetes. However, a large number of patients with PAD go undetected, either because they do not report their symptoms or because they are asymptomatic. It is therefore important to improve detection rates so that these patients can receive appropriate risk factor management.

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“…With increasing ischemia, PAD patients have increasing ischemic myopathy, gait disturbance, rest pain, and/or tissue loss, resulting in increased risk for major amputation 3, 4 . Patients with PAD have abnormal skeletal muscle morphology from persistent ischemia and this leads to limb dysfunction 5 .…”

Section: Introductionmentioning

confidence: 99%

An endovascular model of ischemic myopathy from peripheral arterial disease

Long

Timmins

Koutakis

et al. 2017

Journal of Vascular Surgery

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Objective Peripheral arterial disease (PAD) is a significant age-related medical condition with limited pharmacologic options. Severe PAD, termed critical limb ischemia (CLI), can lead to amputation. Skeletal muscle is the end organ most affected by PAD leading to ischemic myopathy and patient debility. Currently, there are not any therapeutics to treat ischemic myopathy, and proposed biologic agents have not been optimized due to a lack of pre-clinical models of PAD. Since a large animal model of ischemic myopathy may be useful in defining the optimal dosing and delivery regimens, the objective was to create and characterize a swine model of ischemic myopathy that mimics patients with severe PAD. Methods Yorkshire swine (N = 8) underwent acute right hindlimb ischemia via endovascular occlusion of the external iliac artery. The effect of ischemia on limb function, perfusion, and the degree of ischemic myopathy was quantified by weekly gait analysis, arteriography, hindlimb blood pressures, femoral artery duplex ultrasounds, and histologic examination. Animals were terminated at 5 (N = 5) and 6 (N = 3) weeks post-operatively. Ossabaw swine (N = 8) fed a high fat diet were utilized as a model of metabolic syndrome for comparison of arteriogenic recovery and validation of ischemic myopathy. Results There was persistent ischemia in the right hindlimb and occlusion pressures were significantly depressed compared to the untreated left hindlimb out to 6 weeks (SBP 31±21 versus 83±15, respectively; P=0.0007). The blood pressure reduction resulted in a significant increase of ischemic myopathy in the gastrocnemius muscle in the treated limb. Gait analysis revealed a functional deficit of the right hindlimb immediately post-occlusion that improved rapidly over the first 2 weeks. Peak systolic velocity values in the right common femoral artery were severely diminished throughout the entire study (P<0.001), and the hemodynamic environment post-occlusion was characterized by low and oscillatory wall shear stress. Finally, the internal iliac artery on the side of the ischemic limb underwent significant arteriogenic remodeling (1.8x baseline) in the Yorkshire, but not the Ossabaw swine model. Conclusions This model utilizes endovascular technology to produce the first durable large animal model of ischemic myopathy. Acutely (first 2 weeks) this model is associated with impaired gait but no tissue loss. Chronically (2-6 weeks), this model delivers persistent ischemia resulting in ischemic myopathy similar to that seen in PAD patients. This model may be of use for testing novel therapeutics including biologic therapies for promoting neovascularization and arteriogenesis.

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The Basle Longitudinal Study: Report on the relation of initial glucose level to baseline ECG abnormalities, peripheral artery disease, and subsequent mortality

Cited by 64 publications

References 0 publications

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

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

Metabolic, endocrine and haemodynamic risk factors in the patient with peripheral arterial disease

An endovascular model of ischemic myopathy from peripheral arterial disease

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