title: Arterial stiffness, endothelial and cognitive function in subjects with type 2 diabetes in accordance with absence or presence of diabetic foot syndrome.
abstract: Endothelial dysfunction is an early marker of cardiovascular disease so endothelial and arterial stiffness indexes are good indicators of vascular health. We aimed to assess whether the presence of diabetic foot is associated with arterial stiffness and endothelial function impairment.
  
  
  
  We studied 50 subjects with type 2 diabetes mellitus and diabetic foot syndrome (DFS) compared to 50 diabetic subjects without diabetic foot, and 53 patients without diabetes mellitus, by means of the mini mental state examination (MMSE) administered to evaluate cognitive performance. Carotid-femoral pulse wave velocity (PWV) and augmentation index (Aix) were also evaluated by Applanation tonometry (SphygmoCor version 7.1), and the RH-PAT data were digitally analyzed online by Endo-PAT2000 using reactive hyperemia index (RHI) values.
  
  
  
  In comparison to diabetic subjects without diabetic foot the subjects with diabetic foot had higher mean values of PWV, lower mean values of RHI, and lower mean MMSE. At multinomial logistic regression PWV and RHI were significantly associated with diabetic foot presence, whereas ROC curve analysis had good sensitivity and specificity in arterial PWV and RHI for diabetic foot presence.
  
  
  
  Pulse wave velocity and augmentation index, mean RHI values, and mean MMSE were effective indicators of diabetic foot. Future research could address these issues by means of longitudinal studies to evaluate cardiovascular event incidence in relation to arterial stiffness, endothelial and cognitive markers.
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy. bruno.tuttolomondo@unipa.it.|U.O.C di Medicina Interna con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, P.zza delle Cliniche, n.2, 90127, Palermo, Italy. bruno.tuttolomondo@unipa.it.
authors.forename: Antonino
authors.initials: A
authors.lastname: Tuttolomondo
authors.affiliation: Department of Sciences for Health Promotion and Mother Child, University of Palermo, Palermo, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Casuccio
authors.affiliation: Dipartimento di Chirurgia Generale e d'Urgenza, Policlinico Universitario "Paolo GiacconeUniversity of Palermo, Palermo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guercio
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Maida
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Cuore
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Di Raimondo
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Simonetta
authors.affiliation: Chair of Allergology, University of Bari, Bari, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Di Bona
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Pecoraro
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy.
authors.forename: Vittoriano
authors.initials: V
authors.lastname: Della Corte
authors.affiliation: Dipartimento di Chirurgia Generale e d'Urgenza, Policlinico Universitario "Paolo GiacconeUniversity of Palermo, Palermo, Italy.
authors.forename: Eliana
authors.initials: E
authors.lastname: Gulotta
authors.affiliation: Dipartimento di Chirurgia Generale e d'Urgenza, Policlinico Universitario "Paolo GiacconeUniversity of Palermo, Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
mesh_terms: D000368:Aged; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow / Q000502:physiology*; D059289:Vascular Stiffness / Q000502:physiology*
keywords: Cognitive function; Endothelium function; Foot ulcer; Vascular health; Vascular stiffness