title: INFLUENCE OF DIABETES ON AMBULATION AND INFLAMMATION IN MEN AND WOMEN WITH SYMPTOMATIC PERIPHERAL ARTERY DISEASE.
abstract: OBJECTIVE
  To determine whether diabetes and sex were factors associated with ambulatory function, endothelial cell inflammation, oxidative stress, and apoptosis, and with circulating biomarkers of inflammation and antioxidant capacity in patients with peripheral artery disease (PAD) and claudication.
  
  
  METHODS
  Ambulatory function of 180 symptomatic men and women with PAD was assessed during a graded maximal treadmill test, 6-minute walk test, and 4-meter walk test. Patients were further characterized on endothelial effects of circulating factors present in the sera using a cell culture-based bioassay on primary human arterial endothelial cells, and on circulating inflammatory and vascular biomarkers.
  
  
  RESULTS
  Men and women with diabetes had greater prevalence (p = 0.007 and p = 0.015, respectively) of coronary artery disease (CAD) than patients without diabetes. To assure that this difference did not influence planned comparisons, the data set was stratified on CAD. Diabetic men with CAD had a lower peak walking time (PWT) during the treadmill test and a slower 4-meter gait speed compared to non-diabetic men with CAD (p < 0.05). Diabetic women with CAD had a lower PWT compared to their non-diabetic counterparts (p < 0.01). Additionally, diabetic men with CAD had higher pigment epithelium-derived factor (p < 0.05) than their non-diabetic counterparts, and diabetic women with CAD had higher leptin (p < 0.01) and interleukin-8 levels (p < 0.05).
  
  
  CONCLUSIONS
  In patients with PAD, diabetic men and women with CAD had more severe claudication than their non-diabetic counterparts, as measured by shorter PWT, and the men had further ambulatory impairment manifested by slower 4-meter gait speed. Furthermore, the diabetic patients with CAD had elevations in interleukin-8, leptin, and PEDF.
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Gardner
authors.affiliation: Department of Biostatistics and Epidemiology, OUHSC, Oklahoma City, OK.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Parker
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK.
authors.forename: Polly S
authors.initials: PS
authors.lastname: Montgomery
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK.
authors.forename: Danuta
authors.initials: D
authors.lastname: Sosnowska
authors.affiliation: Cardiovascular Section, Department of Medicine, OUHSC, Oklahoma City, OK.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Casanegra
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Ungvari
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK.
authors.forename: Anna
authors.initials: A
authors.lastname: Csiszar
authors.affiliation: Departments of Ophthalmology and Biochemistry, University at Buffalo & SUNY Eye Institute, the State University of New York, Buffalo, NY.
authors.forename: Sarah X
authors.initials: SX
authors.lastname: Zhang
authors.affiliation: Departments of Ophthalmology and Biochemistry, University at Buffalo & SUNY Eye Institute, the State University of New York, Buffalo, NY.
authors.forename: Josh J
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK.
authors.forename: William E
authors.initials: WE
authors.lastname: Sonntag
keywords: Claudication; Exercise; Mobility; Peripheral Vascular Disease
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