title: Non-traditional cardiovascular risk factors contribute to peripheral arterial disease in patients with type 2 diabetes.
abstract: OBJECTIVE
  This study evaluated the prevalence of peripheral arterial disease (PAD) in type 2 diabetes and its association with traditional and non-traditional cardiovascular (CV) risk factors.
  
  
  METHODS
  In 1610 type 2 diabetics PAD was defined as ankle-brachial pressure index (ABPI)<0.9.
  
  
  RESULTS
  PAD prevalence was 17%, increased with age, diabetes duration, HbA 1c levels, previous CV events. There were no significant differences in the prevalence of traditional CV risk factors between patients with and without PAD. PAD patients had higher levels of fibrinogen (10.88+/-2.32 versus 10.2+/-2.23micromol/L; p<0.0001), uric acid (327.1+/-89.2 versus 315.2+/-83.3micromol/L, p<0.01), pulse pressure (70+/-18 versus 60+/-16mm Hg, p<0.0001), higher rate of microalbuminuria (21.3% versus 13.7%; p<0.05) and lower glomerular filtration rate (GFR, 80.7+/-24 versus 89.9+/-22 ml/min/1.73 m2; p<0.001) than those without. In age-gender-adjusted analysis, smoking (OR 1.5; CI: 1.07-2.2), HbA 1c (OR 1.45; CI: 1.07-2.08), high pulse pressure (OR 2.81; CI: 1.63-4.82), reduced GFR (OR 2.16; CI: 1.4-3.3), microalbuminuria (OR 1.62; CI: 1.11-2.36), high fibrinogen levels (OR 2.03; CI: 1.34-3.07) were associated with PAD. In multivariate analysis age, male sex, smoking, high pulse pressure, low GFR, high fibrinogen levels, previous CV events were independent risk factors for PAD.
  
  
  CONCLUSIONS
  PAD prevalence is high in Type 2 diabetic patients. Non-traditional cardiovascular risk factors may be involved in the development of this complication.
authors.affiliation: Department of Endocrinology and Metabolism - Section of Diabetes and Metabolism, University of Pisa, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bianchi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Penno
authors.forename: Francesca
authors.initials: F
authors.lastname: Pancani
authors.forename: Alessia
authors.initials: A
authors.lastname: Civitelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Piaggesi
authors.forename: Francesco
authors.initials: F
authors.lastname: Caricato
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellegrini
authors.forename: Stefano
authors.initials: S
authors.lastname: Del Prato
authors.forename: Roberto
authors.initials: R
authors.lastname: Miccoli
mesh_terms: D000368:Aged; D000842:Ankle; D001794:Blood Pressure; D001916:Brachial Artery; D002318:Cardiovascular Diseases / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D011674:Pulse; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D005340:Fibrinogen; D006442:Glycated Hemoglobin