title: [Peripheral arterial disease of the lower limbs in African diabetic patients: ultrasonography and determining factors].
abstract: BACKGROUND
  Diabetic peripheral arterial disease (PAD) of the lower limbs is underdiagnosed.
  
  
  METHODS
  This was a prospective study conducted over a six-month period from November 2012 to April 2013. A total of 308 diabetic patients were included from three diabetes centers in Abidjan (Ivory Coast).
  
  
  OBJECTIVE
  To screen for PAD of the lower limbs in a diabetic population and to identify the determining factors.
  
  
  RESULTS
  Among the 308 patients, the ankle-brachial index (ABI) was<0.9 in 68 (22.07%) patients considered to have PAD; the ABI was>1.3 in 56 (18.2%) patients who had suspected mediacalcosis. The average age of the PAD patients was 60.2 years. Female gender predominated (55.9%). The mean duration of diabetes was 9.6 years: 97.1% type 2 diabetes. The other cardiovascular risk factors in this population were hypertension (58.8%) and dyslipidemia (40.9%). Smoking was present in 29.4% of patients and obesity in 23.9%. PAD of the lower limbs was mild in 46 patients (67.6%), moderate in 16 (23.5%) and severe in 6 (8.8%). Duplex Doppler commonly showed lesions of the tibial arteries. Determining factors of diabetic PAD of the lower limbs were hypertension (58.8% vs 36.6%; OR=2.46; 95% CI: 1.13-5.36; P=0.034) and dyslipidemia (40.9% vs 8.3%; OR=7.6; 95% CI: 2.31-25.08; P=0.0009). For mediacalcosis, male gender (71.5% vs 39.7; OR=0.26 95% CI/0.10-0.64. P=0.004) was the only factor identified.
  
  
  CONCLUSIONS
  Hypertension and dyslipidemia were predictive factors for diabetic PAD of the lower limbs in our African population.
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire. Electronic address: koninchristophe@yahoo.fr.
authors.forename: C
authors.initials: C
authors.lastname: Konin
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: A S
authors.initials: AS
authors.lastname: Essam N'loo
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: A
authors.initials: A
authors.lastname: Adoubi
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: I
authors.initials: I
authors.lastname: Coulibaly
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: R
authors.initials: R
authors.lastname: N'guetta
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: B
authors.initials: B
authors.lastname: Boka
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: J J
authors.initials: JJ
authors.lastname: N'djessan
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: J
authors.initials: J
authors.lastname: Koffi
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: H
authors.initials: H
authors.lastname: Yao
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: I
authors.initials: I
authors.lastname: Angoran
authors.affiliation: Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: M
authors.initials: M
authors.lastname: Adoh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D044383:Black People; D002114:Calcinosis / Q000000981:diagnostic imaging; D007560:Cote d'Ivoire; D048909:Diabetes Complications / Q000000981:diagnostic imaging*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D007592:Joint Diseases / Q000000981:diagnostic imaging; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D017540:Tunica Media; D014463:Ultrasonography; D014652:Vascular Diseases / Q000000981:diagnostic imaging
keywords: Artériopathie oblitérante des membres inférieurs; Diabetes; Diabète; Dyslipidemia; Hypercholestérolémie; Hypertension; Hypertension artérielle; Mediacalcosis; Médiacalcose; Peripheral arterial disease; Ultrasons