title: Diverging effects of diabetes mellitus in patients with peripheral artery disease and abdominal aortic aneurysm and the role of advanced glycation end-products: ARTERY study - protocol for a multicentre cross-sectional study.
abstract: Diabetes mellitus is a well-defined risk factor for peripheral artery disease (PAD), but protects against the development and growth of abdominal aortic aneurysm (AAA). Diabetes mellitus is associated with arterial stiffening and peripheral arterial media sclerosis. Advanced glycation end-products (AGEs) are increased in diabetes mellitus and cardiovascular disease. AGEs are known to form cross-links between proteins and are associated with arterial stiffness. Whether AGEs contribute to the protective effects of diabetes mellitus in AAA is unknown. Therefore, the ARTERY (Advanced glycation end-pRoducts in patients with peripheral arTery disEase and abdominal aoRtic aneurYsm) study is designed to evaluate the role of AGEs in the diverging effects of diabetes mellitus on AAA and PAD.
  
  
  
  This cross-sectional multicentre study will compare the amount, type and location of AGEs in the arterial wall in a total of 120 patients with AAA or PAD with and without diabetes mellitus (n=30 per subgroup). Also, local and systemic vascular parameters, including pulse wave velocity, will be measured to evaluate the association between arterial stiffness and AGEs. Finally, AGEs will be measured in serum, urine, and assessed in skin with skin autofluorescence using the AGE Reader.
  
  
  
  This study is approved by the Medical Ethics committees of University Medical Center Groningen, Martini Hospital and Medisch Spectrum Twente, the Netherlands. Study results will be disseminated through peer-reviewed journals and scientific events.
  
  
  
  trialregister.nl NTR 5363.
authors.affiliation: Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: L C
authors.initials: LC
authors.lastname: de Vos
authors.affiliation: Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Boersema
authors.affiliation: Department of Pathology and Medical Biology, Division of Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: J L
authors.initials: JL
authors.lastname: Hillebrands
authors.affiliation: Department of Internal Medicine, Laboratory for Metabolism and Vascular Medicine, Maastricht University, Maastricht, the Netherlands.
authors.forename: C G
authors.initials: CG
authors.lastname: Schalkwijk
authors.affiliation: Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Meerwaldt
authors.affiliation: Department of Vascular Surgery, Martini Hospital, Groningen, the Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: Breek
authors.affiliation: Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Smit
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.affiliation: Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: J D
authors.initials: JD
authors.lastname: Lefrandt
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000378:metabolism* / Q000601:surgery; D001158:Arteries / Q000378:metabolism; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000378:metabolism*; D004691:Endarterectomy; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D009426:Netherlands; D058729:Peripheral Arterial Disease / Q000453:epidemiology / Q000378:metabolism* / Q000601:surgery; D012077:Renal Artery / Q000378:metabolism*; D059289:Vascular Stiffness; D014656:Vascular Surgical Procedures
chemical_list: D017127:Glycation End Products, Advanced
keywords: Abdominal aortic aneurysm; Advanced glycation end products; Diabetes mellitus; Peripheral artery disease