High prevalence of asymptomatically poor muscle perfusion of lower extremities measured in type II diabetes patients with abnormal myocardial perfusion.
Foot problems are the most common cause of hospital admission in patients with type II diabetes mellitus (DM). Poor muscle perfusion of lower extremities is thought to be the major component in the pathogenesis of foot problems. Therefore, it is important and interesting to investigate if high prevalence of poor muscle perfusion of lower extremities in type II DM patients with abnormal myocardial perfusion and more cardiovascular risk factors. We used a well-established and noninvasive radionuclide method (Xe-133 muscle washout) to objectively evaluate the anterior tibial muscle perfusion of 60 type II DM male patients without symptoms/signs of peripheral vascular disease (PVD) in the lower extremities. The patients were separated into groups according to the myocardial perfusion imaging results and cardiovascular risk factor survey. Meanwhile, 30 normal male controls with a matched age distribution were also included for comparison. The muscle perfusions were of significant difference (P-values <.05) between (1) 60 type II DM patients (1.84+/-0.43 ml/100 g/min) and 30 normal controls (2.95+/-0.52 ml/100 g/min), (2) 24 patients with abnormal myocardial perfusion (1.31+/-0.45 ml/100 g/min) and 36 patients with normal myocardial perfusion (2.24+/-0.48 ml/100 g/min), as well as (3) 28 patients with more cardiovascular risk factors (1.33+/-0.46 ml/100 g/min) and 22 patient with less cardiovascular risk factors (2.22+/-0.49 ml/100 g/min). Based on Xe-133 muscle washout method, we concluded that the muscle perfusion in the lower extremities of type II DM patients without symptoms/signs of PVD is significantly decreased and related to abnormal myocardial perfusion and more cardiovascular risk factors.
Cardiovascular Division, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Ching Cheng
CC
Lin
Hueisch Jy
HJ
Ding
Ruoh Fang
RF
Yen
Jhi Joung
JJ
Wang
Shung Tai
ST
Ho
Albert
A
Kao
D000368:Aged; D002318:Cardiovascular Diseases / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply*; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011877:Radionuclide Imaging; D012016:Reference Values; D012039:Regional Blood Flow; D012307:Risk Factors