A cross-sectional study of the effects of type 2 diabetes and other cardiovascular risk factors on structure and function of nonstenotic arteries of the lower limb.
OBJECTIVE
To compare intimal-medial thickness (IMT) and pulse wave conduction velocity (PWCV) in unstenosed arteries of the lower limb in subjects with and without type 2 diabetes and to determine the contribution of a range of cardiovascular risk factors.


METHODS
IMT and PWCV were determined in lower-limb arteries of 79 subjects with diabetes and 77 euglycemic subjects. Plasma lipids were determined by enzymatic assays, and LDL particle size was measured by gradient gel electrophoresis. Lag time for copper-induced oxidation of LDL was determined. alpha-Tocopherol, retinol, and ascorbate levels were determined by high-performance liquid chromatography, soluble E-selectin by enzyme-linked immunosorbent assay, and fibrinogen and factor VII by automated assays.


RESULTS
Subjects with diabetes had greater superficial femoral artery (SFA) IMT, popliteal artery (PA) IMT, and SFA PWCV (all P < 0.0001). In univariate analysis, IMT and PWCV correlated with increased waist-to-hip ratio, triglycerides, and fibrinogen and inversely with HDL cholesterol and LDL size. Ascorbate was inversely associated with IMT, and LDL lag time was inversely correlated with PWCV. Subjects with the greatest number of features of the metabolic syndrome had the highest IMT and PWCV.


CONCLUSIONS
Adverse changes in the structure and function of unstenosed lower-limb arteries are present in type 2 diabetes and are associated with features of the metabolic syndrome.
O'Neal
David N
DN
University of Melbourne Department of Medicine, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia. jdbest@unimelb.edu.au
Dragicevic
George
G
Rowley
Kevin G
KG
Ansari
Mohamed Z
MZ
Balazs
Nicholas
N
Jenkins
Alicia
A
Best
James D
JD
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000473:pathology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology; D014463:Ultrasonography