title: Pulse pressure and Michigan Neuropathy Screening Instrument are independently associated with asymptomatic peripheral arterial disease among type 2 diabetes community residents: a community-based screening program in Taiwan.
abstract: BACKGROUND
  Peripheral arterial disease (PAD) is one of the major manifestations of systemic atherosclerosis and plays an important role in low-extremity amputation in type 2 diabetic patients. The aim of this study was to explore the prevalence and risk factors for asymptomatic PAD in type 2 diabetic community residents.
  
  
  METHODS
  This cross-sectional study enrolled 552 type 2 diabetic adults (232 men and 320 women) without subjective symptoms of intermittent claudication. We defined the PAD group as an ankle-brachial index (ABI) ≤ 0.90, and the normal group as an ABI 0.91-1.30. Their clinical characteristics, Michigan Neuropathy Screening Instrument (MNSI) scores and blood pressure were compared.
  
  
  RESULTS
  We discovered that 51 patients have asymptomatic PAD. Univariate logistic regression analysis revealed that age, history of stroke, longer duration of diabetes (> 10 years), unemployment or retirement, pulse pressure, systolic blood pressure, and high MNSI score (> 2) were risk factors for PAD. By multivariate logistic regression analysis, pulse pressure, high MNSI score, age, and history of stroke were independent risk factors with odds ratios (95% confidence intervals, CI) of 1.032 (1.012-1.053), 2.359 (1.274-4.370), 1.050 (1.010-1.091), and 5.152 (1.985-13.368), respectively. Furthermore, the prevalence of PAD increased significantly with increment in the pulse pressure and MNSI.
  
  
  CONCLUSIONS
  In summary, the overall prevalence of asymptomatic PAD in the type 2 diabetic adults was 9.2%. Age, history of stroke, pulse pressure and MNSI score may provide important clinical information. Primary care physicians should be aware of asymptomatic patients with high pulse pressure and MNSI scores.
authors.forename: Li-Chi
authors.initials: LC
authors.lastname: Fan
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
authors.forename: Wei-Chao
authors.initials: WC
authors.lastname: Huang
authors.forename: Cheng
authors.initials: C
authors.lastname: Ho
authors.forename: Pao-Yin
authors.initials: PY
authors.lastname: Chen
authors.forename: Jui-Chu
authors.initials: JC
authors.lastname: Huang
authors.forename: Hsu-Huei
authors.initials: HH
authors.lastname: Weng
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Yun-Shing
authors.initials: YS
authors.lastname: Peng
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index / Q000295:instrumentation / Q000379:methods; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D018570:Risk Assessment; D013624:Taiwan