Medial arterial calcification in the feet of diabetic patients and matched non-diabetic control subjects.
The prevalence and distribution of medial arterial calcification was assessed in the feet of four subject groups; 54 neuropathic diabetic patients with previous foot ulceration (U), median age 60.5 (50.5-67 interquartile range) years, duration of diabetes 19.5 (9.9-29.9) years; 40 neuropathic diabetic patients without a foot ulcer history (N), age 68 (62-73) years, duration of diabetes 14.0 (8.0-28.0) years; 43 non-neuropathic diabetic patients (NN), age 60.5 (52-68.5) years, duration of diabetes 14.0 (8.0-28.0) years and 50 non-diabetic control subjects, age 62.5 (53.7-70) years. A single radiologist graded medial arterial calcification as absent, mild or severe, at the ankle, hind-foot, mid-foot, metatarsals and toes on standardised plain lateral and antero-posterior foot radiographs taken by a single radiographer. Diabetes history, vibration perception threshold, ankle systolic pressure and serum creatinine were also assessed. Medial arterial calcification was significantly greater (total score 18 [3-31]) in neuropathic diabetic patients with previous ulceration (U vs N p < 0.01, U vs NN p < 0.001). Non-neuropathic diabetic patients did not have significantly higher arterial calcification scores than age-matched non-diabetic control subjects. Medial arterial calcification correlated with vibration perception threshold (r = 0.35), duration of diabetes (r = 0.32) and serum creatinine (r = 0.41), (all p < 0.01). Logistic regression models showed vibration perception and duration of diabetes to predict the probability of any calcification. Serum creatinine level was added to predict severe calcification.(ABSTRACT TRUNCATED AT 250 WORDS)
Young
M J
MJ
University Department of Medicine, Manchester Royal Infirmary, UK.
Adams
J E
JE
Anderson
G F
GF
Boulton
A J
AJ
Cavanagh
P R
PR
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000453:epidemiology* / Q000503:physiopathology; D001794:Blood Pressure; D002114:Calcinosis / Q000453:epidemiology* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D005534:Foot Diseases / Q000453:epidemiology* / Q000503:physiopathology; D016523:Foot Ulcer / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D012044:Regression Analysis