Peripheral artery disease and exertional leg symptoms in diabetes patients in Ghana.
BACKGROUND
Peripheral arterial disease (PAD) is a major health problem in diabetes patients in high-income countries, but the PAD burden in sub-Saharan Africa is largely undetermined. We studied the prevalence of PAD and exertional leg symptoms in diabetes (DM) patients in a tertiary hospital in Ghana.


METHODS
In a case control study design, 485 DM and 330 non-diabetes participants were recruited. PAD was diagnosed as Ankle Brachial Index (ABI) < 0.9. Edinburgh Claudication Questionnaire (ECQ) was used to assess exertional leg symptoms.


RESULTS
The overall prevalence of classical intermittent claudication was 10.3 % and ABI-diagnosed PAD was 26.7 %, with 3.5 % of the participants having both classic intermittent claudication and ABI-diagnosed PAD. The prevalence of exertional leg symptoms were similar in diabetes patients with and without PAD. In non-diabetes participants, intermittent claudication and rest pain were higher in PAD patients than in non-PAD participants. In multivariable logistic regression, intermittent claudication [OR (95 % CI), 3.39 (1.14 - 8.1), p < 0.05] and rest pain [4.3 (1.58 - 9.67), p < 0.001] were independently associated with PAD in non-diabetes group, and rest pain [1.71 (1.13 - 2.17), p < 0.05] was associated with PAD in all participants.


CONCLUSIONS
There is high burden of PAD and exertional leg pains in DM patients in Ghana. PAD is expressed as intermittent claudication and rest pain in non-diabetes individuals.
Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Accra, Ghana. melvinky@gmail.com.
Kwame
K
Yeboah
Department of Medicine & Therapeutics, School of Medicine & Dentistry, University of Ghana, Accra, Ghana.
Peter
P
Puplampu
Department of Dietetics, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
Joana
J
Ainuson
Department of Medicine & Therapeutics, School of Medicine & Dentistry, University of Ghana, Accra, Ghana.
Josephine
J
Akpalu
Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Ghana.
Ben
B
Gyan
Department of Medicine & Therapeutics, School of Medicine & Dentistry, University of Ghana, Accra, Ghana.|National Diabetes Management & Research Centre, Korle-Bu Teaching Hospital, Accra, Ghana.
Albert G B
AG
Amoah
D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000453:epidemiology*; D007511:Ischemia / Q000175:diagnosis / Q000453:epidemiology*; D016015:Logistic Models; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
Ankle brachial index; Diabetes; Exertional leg symptoms; Ghana; Peripheral arterial disease