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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2004 June;23(2):134-8

lingua: Inglese

Prev­a­lence of lower limb occlu­sive vas­cu­lar dis­ease in out­clin­ic dia­betic ­patients

Andrade J. L., Schlaad S. W., Koury Junior A., Van Bellen B.

Divi­sion of Vas­cu­lar Sur­gery, ­Beneficência Por­tu­gue­sa Hos­pi­tal, São Paulo, Bra­zil


Aim. The aim of this study was to deter­mine the prev­a­lence and risk fac­tors for periph­er­al occlu­sive vas­cu­lar dis­ease (POVD) in sub­jects with dia­betes mel­lit­us (DM) in Bra­zil.
Meth­ods. We eval­u­at­ed 236 dia­bet­ic indi­vid­u­als, in spon­ta­ne­ous ­demand, rep­re­sent­ing 471 legs. POVD was ­assessed by the ankle bra­chi­al index (ABI).
­Results. The mean age was 62.1 years (range 22-89 years), 52% were male, 93.2% type II DM and the mean time to diag­no­sis was 7.9 years (range 0-37 years). Sixty per­cent were hyper­ten­sives. In 61% at least one pulse was dimin­ished or ­absent. The prev­a­lence of ische­mia was 18% (ABI<0.9) while 22% had an ABI com­pat­ible with high grade arte­ri­al cal­cifi­ca­tion (ABI>1.3). Over­all less than 1/3 of the cases had the vas­cu­lar exam that could be con­sid­ered nor­mal. The ABI was lower in sub­jects with pulse def­i­cit (p<0.001), and a nor­mal pulse had a neg­a­tive pre­dic­tive value for ische­mia of more than 90%. Sub­jects with nor­mal puls­es were young­er and had a ­decreased dia­betes dura­tion (p<0.001 and p<0.05, respec­tive­ly). An ­increase in the dura­tion of the dia­betes was asso­ciat­ed with a pro­gres­sive ­decrease in the ABI (p<0.01). ­Female gen­der and hyper­ten­sion were asso­ciat­ed with a ­reduced ABI (p<0.01 and p<0.05, respec­tive­ly).
Con­clu­sion. There is a high prev­a­lence of POVD in dia­bet­ic indi­vid­u­als. The dis­ease is asso­ciat­ed with hyper­ten­sion and ­female gen­der and gets worse with increas­ing dura­tion of the dia­betes.

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