title: US assessment of medial arterial calcification: a sensitive marker of diabetes-related microvascular and macrovascular complications.
abstract: OBJECTIVE
  To examine the sensitivity of ultrasonography (US) compared with conventional radiography in detection of lower limb (thigh) medial arterial calcification (MAC) in type 2 diabetic patients and evaluate its association with diabetes-related complications.
  
  
  METHODS
  The study was approved by the local research ethics committee, and informed written consent was obtained. US was performed in 289 patients with type 2 diabetes mellitus, and MAC severity was assigned a score from 0 to 8. Among the patients, 263 underwent radiographic examinations. All subjects underwent clinical evaluation to detect the presence of diabetes-related complications.
  
  
  RESULTS
  US helped detect MAC in more subjects compared with radiography (65.8% vs 12.2%). US helped detect MAC from mild (scores 1-4) to severe (scores 5-8) degrees, while mild degree of MAC was poorly demonstrated with radiography. The incidence of nephropathy, retinopathy, sensory neuropathy, and macrovascular complications increased with the severity of MAC (based on US scoring). With univariate analysis, the presence of MAC was associated with nephropathy (P<.001), retinopathy (P<.001), sensory neuropathy (P=.004), and macrovascular complications (P<.001). After adjustment for potential confounders, the presence of severe MAC was associated with nephropathy, retinopathy, and macrovascular complications, with the odds ratios of 3.4 (95% confidence interval [CI]: 1.53, 7.43; P=.003), 2.6 (95% CI: 1.22, 5.32; P=.013), and 3.8 (95% CI: 1.37, 10.6; P=.01), respectively.
  
  
  CONCLUSIONS
  In type 2 diabetic Chinese patients, US was more sensitive than conventional radiography in the detection of MAC, particularly when the MAC was mild. The presence of severe MAC was associated with diabetic nephropathy, retinopathy, and macrovascular complications. US detection of MAC was a potential early marker to identify diabetes-related complications.
authors: Department of Diagnostic Imaging and Interventional Radiology, the Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing St, Shatin, NT, Hong Kong SAR, China.
authors: Kin Hung
authors: KH
authors: Liu
authors: Winnie Chiu Wing
authors: WC
authors: Chu
authors: Alice Pik Shan
authors: AP
authors: Kong
authors: Gary Tin
authors: GT
authors: Choi Ko
authors: Ronald Ching Wan
authors: RC
authors: Ma
authors: Jeff Wai Sang
authors: JW
authors: Chan
authors: Louis T C
authors: LT
authors: Chow
authors: Darshana D
authors: DD
authors: Rasalkar
authors: Wing Yee
authors: WY
authors: So
authors: Lung Fung
authors: LF
authors: Tse
authors: Heidi Samantha
authors: HS
authors: Corcoran
authors: Risa
authors: R
authors: Ozaki
authors: Anil T
authors: AT
authors: Ahuja
authors: Juliana Chung Ngor
authors: JC
authors: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D050380:Monckeberg Medial Calcific Sclerosis / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography