title: Prevalence of peripheral vascular disease and its association with carotid intima-media thickness and arterial stiffness in type 2 diabetes: the Chennai urban rural epidemiology study (CURES 111).
abstract: We investigated the prevalence of peripheral vascular disease (PVD) and its association with preclinical atherosclerotic markers [intima-media thickness (IMT)] and arterial stiffness among 1755 urban south Indian type 2 diabetic subjects recruited from the Chennai Urban Rural Epidemiology Study (CURES). Doppler studies were performed, and PVD was defined as ankle-brachial index (ABI) of ≤0.9. IMT of the common carotid artery was determined using high-resolution B-mode ultrasonography, and augmentation index (AGI) was measured using the Sphygmocor apparatus. The overall prevalence of PVD was 8.3% (age-standardized 6.5%). The prevalence of PVD was higher among known diabetic subjects (n = 1401) compared to newly detected diabetic subjects (n = 354) (8.6% vs 6.8%, p = 0.250). The mean IMT and AGI in subjects with PVD were significantly higher compared to subjects without PVD (IMT: 0.99 ± 0.26 mm vs 0.83 ± 0.19 mm; AGI: 28.1 ± 9.6% vs 25.7 ± 9.8%, respectively). IMT was independently associated with PVD even after adjusting for age [odds ratio (OR) = 2.9 (1.2-6.7), p = 0.016 for second tertile and OR = 3.9 (1.7-9.3), p = 0.002 for third tertile compared to first tertile]. AGI was also associated with PVD in the unadjusted model [OR = 1.8 (1.1-3.1), p = 0.027 for second tertile compared to first tertile]. However, when adjusted for age, the significance was lost. In conclusion, among urban south Indian type 2 diabetic subjects, the prevalence of PVD is 8.3% and IMT is more strongly associated with PVD than AGI.
authors.affiliation: Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and IDF Centre for Education, Chennai, India.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Pradeepa
authors.forename: Sundarapandi
authors.initials: S
authors.lastname: Chella
authors.forename: Jayagopi
authors.initials: J
authors.lastname: Surendar
authors.forename: Karunakaran
authors.initials: K
authors.lastname: Indulekha
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D012737:Sex Factors; D014505:Urban Population / Q000706:statistics & numerical data; D059289:Vascular Stiffness
keywords: Peripheral vascular disease; South Asians; arterial stiffness; diabetes; doppler; intima-media thickness; prevalence