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Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes

BACKGROUND: Little is known about the evolution of peripheral arterial disease (PAD) since diagnosis and its association with glycemic and lipid control in patients with Type 2 Diabetes Mellitus (T2DM). OBJECTIVE: Evaluate the actual criteria to start screening PAD with ankle-brachial index (ABI) in...

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Autores principales: Felício, João Soares, de Melo, Franciane Trindade Cunha, Vieira, Giovana Miranda, de Aquino, Vitória Teixeira, de Souza Parente, Fernanda, da Silva, Wanderson Maia, Said, Nivin Mazen, da Silva, Emanuele Rocha, de Souza, Ana Carolina Contente Braga, de Oliveira, Maria Clara Neres Iunes, de Lemos, Gabriela Nascimento, de Souza, Ícaro José Araújo, de Alcântara, Angélica Leite, de Moraes, Lorena Vilhena, Abrahão Neto, João Felício, de Queiroz, Natércia Neves Marques, Mourão, Neyla Arroyo Lara, Piani, Pedro Paulo Freire, Oliveira dos Reis, Melissa de Sá, Felício, Karem Mileo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238109/
https://www.ncbi.nlm.nih.gov/pubmed/35761179
http://dx.doi.org/10.1186/s12872-022-02722-6
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author Felício, João Soares
de Melo, Franciane Trindade Cunha
Vieira, Giovana Miranda
de Aquino, Vitória Teixeira
de Souza Parente, Fernanda
da Silva, Wanderson Maia
Said, Nivin Mazen
da Silva, Emanuele Rocha
de Souza, Ana Carolina Contente Braga
de Oliveira, Maria Clara Neres Iunes
de Lemos, Gabriela Nascimento
de Souza, Ícaro José Araújo
de Alcântara, Angélica Leite
de Moraes, Lorena Vilhena
Abrahão Neto, João Felício
de Queiroz, Natércia Neves Marques
Mourão, Neyla Arroyo Lara
Piani, Pedro Paulo Freire
Oliveira dos Reis, Melissa de Sá
Felício, Karem Mileo
author_facet Felício, João Soares
de Melo, Franciane Trindade Cunha
Vieira, Giovana Miranda
de Aquino, Vitória Teixeira
de Souza Parente, Fernanda
da Silva, Wanderson Maia
Said, Nivin Mazen
da Silva, Emanuele Rocha
de Souza, Ana Carolina Contente Braga
de Oliveira, Maria Clara Neres Iunes
de Lemos, Gabriela Nascimento
de Souza, Ícaro José Araújo
de Alcântara, Angélica Leite
de Moraes, Lorena Vilhena
Abrahão Neto, João Felício
de Queiroz, Natércia Neves Marques
Mourão, Neyla Arroyo Lara
Piani, Pedro Paulo Freire
Oliveira dos Reis, Melissa de Sá
Felício, Karem Mileo
author_sort Felício, João Soares
collection PubMed
description BACKGROUND: Little is known about the evolution of peripheral arterial disease (PAD) since diagnosis and its association with glycemic and lipid control in patients with Type 2 Diabetes Mellitus (T2DM). OBJECTIVE: Evaluate the actual criteria to start screening PAD with ankle-brachial index (ABI) in T2DM patients and assess its progression and relationship with glycemic and lipid control since diagnosis. METHODS: We performed a 3-year prospective cohort study with two groups: group 1 (978 individuals with T2DM undergoing drug treatment) and group 2 [221 newly diagnosed drug-naive (< 3 months) patients with T2DM]. PAD diagnosis was by ABI ≤ 0.90, regardless any symptoms. RESULTS: As expected, abnormal ABI prevalence was higher in group 1 vs. Group 2 (87% vs. 60%, p < 0.001). However, abnormal ABI prevalence did not differ between patients over and under 50 years in both groups. Our drug-naive group stabilizes ABI (0.9 ± 0.1 vs 0.9 ± 0.1, p = NS) and improved glycemic and lipid control during follow-up [glycated hemoglobin (HbA1c) = 8.9 ± 2.1 vs 8.4 ± 2.3%, p < 0.05; LDL = 132 ± 45 vs 113 ± 38 mg/dL, p < 0.01, respectively]. When compared, patients who evolved with normalization or maintained normal ABI levels at the end [Group A, N = 60 (42%)] with those who decreased ABI to abnormal levels (ABI basal 1.0 ± 0.1 vs final 0.85 ± 0.1, p < 0.001) [Group B, N = 26 (18%)], an improvement in HbA1c (9 ± 2 vs 8 ± 2%, p < 0.05) and a correlation between the final HbA1c with ABI (r = − 0.3, p = 0.01) was found only in the first. In addition, a correlation was found between albuminuria variation and ABI solely in group A (r = − 0.3; p < 0.05). CONCLUSION: Our study suggests that ABI should be measured at diagnosis in T2DM patients, indicating that current criteria to select patients to screen PAD with ABI must be simplified. An improvement in albuminuria and glycemic and lipid control could be related with ABI normalization in newly diagnosed T2DM drug-naive patients.
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spelling pubmed-92381092022-06-29 Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes Felício, João Soares de Melo, Franciane Trindade Cunha Vieira, Giovana Miranda de Aquino, Vitória Teixeira de Souza Parente, Fernanda da Silva, Wanderson Maia Said, Nivin Mazen da Silva, Emanuele Rocha de Souza, Ana Carolina Contente Braga de Oliveira, Maria Clara Neres Iunes de Lemos, Gabriela Nascimento de Souza, Ícaro José Araújo de Alcântara, Angélica Leite de Moraes, Lorena Vilhena Abrahão Neto, João Felício de Queiroz, Natércia Neves Marques Mourão, Neyla Arroyo Lara Piani, Pedro Paulo Freire Oliveira dos Reis, Melissa de Sá Felício, Karem Mileo BMC Cardiovasc Disord Research BACKGROUND: Little is known about the evolution of peripheral arterial disease (PAD) since diagnosis and its association with glycemic and lipid control in patients with Type 2 Diabetes Mellitus (T2DM). OBJECTIVE: Evaluate the actual criteria to start screening PAD with ankle-brachial index (ABI) in T2DM patients and assess its progression and relationship with glycemic and lipid control since diagnosis. METHODS: We performed a 3-year prospective cohort study with two groups: group 1 (978 individuals with T2DM undergoing drug treatment) and group 2 [221 newly diagnosed drug-naive (< 3 months) patients with T2DM]. PAD diagnosis was by ABI ≤ 0.90, regardless any symptoms. RESULTS: As expected, abnormal ABI prevalence was higher in group 1 vs. Group 2 (87% vs. 60%, p < 0.001). However, abnormal ABI prevalence did not differ between patients over and under 50 years in both groups. Our drug-naive group stabilizes ABI (0.9 ± 0.1 vs 0.9 ± 0.1, p = NS) and improved glycemic and lipid control during follow-up [glycated hemoglobin (HbA1c) = 8.9 ± 2.1 vs 8.4 ± 2.3%, p < 0.05; LDL = 132 ± 45 vs 113 ± 38 mg/dL, p < 0.01, respectively]. When compared, patients who evolved with normalization or maintained normal ABI levels at the end [Group A, N = 60 (42%)] with those who decreased ABI to abnormal levels (ABI basal 1.0 ± 0.1 vs final 0.85 ± 0.1, p < 0.001) [Group B, N = 26 (18%)], an improvement in HbA1c (9 ± 2 vs 8 ± 2%, p < 0.05) and a correlation between the final HbA1c with ABI (r = − 0.3, p = 0.01) was found only in the first. In addition, a correlation was found between albuminuria variation and ABI solely in group A (r = − 0.3; p < 0.05). CONCLUSION: Our study suggests that ABI should be measured at diagnosis in T2DM patients, indicating that current criteria to select patients to screen PAD with ABI must be simplified. An improvement in albuminuria and glycemic and lipid control could be related with ABI normalization in newly diagnosed T2DM drug-naive patients. BioMed Central 2022-06-27 /pmc/articles/PMC9238109/ /pubmed/35761179 http://dx.doi.org/10.1186/s12872-022-02722-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Felício, João Soares
de Melo, Franciane Trindade Cunha
Vieira, Giovana Miranda
de Aquino, Vitória Teixeira
de Souza Parente, Fernanda
da Silva, Wanderson Maia
Said, Nivin Mazen
da Silva, Emanuele Rocha
de Souza, Ana Carolina Contente Braga
de Oliveira, Maria Clara Neres Iunes
de Lemos, Gabriela Nascimento
de Souza, Ícaro José Araújo
de Alcântara, Angélica Leite
de Moraes, Lorena Vilhena
Abrahão Neto, João Felício
de Queiroz, Natércia Neves Marques
Mourão, Neyla Arroyo Lara
Piani, Pedro Paulo Freire
Oliveira dos Reis, Melissa de Sá
Felício, Karem Mileo
Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes
title Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes
title_full Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes
title_fullStr Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes
title_full_unstemmed Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes
title_short Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes
title_sort peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238109/
https://www.ncbi.nlm.nih.gov/pubmed/35761179
http://dx.doi.org/10.1186/s12872-022-02722-6
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