Association of glucose metabolism, smoking and cardiovascular risk factors with incident peripheral arterial disease: the DESIR study.

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  • Additional Information
    • Corporate Authors:
      DESIR Study Group
    • Source:
      Publisher: Elsevier Country of Publication: Ireland NLM ID: 0242543 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0021-9150 (Print) Linking ISSN: 00219150 NLM ISO Abbreviation: Atherosclerosis Subsets: MEDLINE
    • Publication Information:
      Publication: Limerick : Elsevier
      Original Publication: Amsterdam, Elsevier.
    • Subject Terms:
      Diabetes Mellitus, Type 2/*epidemiology ; Glucose/*metabolism ; Glucose Intolerance/*epidemiology ; Peripheral Vascular Diseases/*epidemiology ; Smoking/*epidemiology; Adult ; Aged ; Diabetes Mellitus, Type 2/metabolism ; Disease Progression ; Female ; France/epidemiology ; Glucose Intolerance/metabolism ; Humans ; Incidence ; Insulin Resistance ; Logistic Models ; Longitudinal Studies ; Male ; Middle Aged ; Peripheral Vascular Diseases/metabolism ; Risk Factors ; Smoking/metabolism
    • Abstract:
      Aims: We determined the 6-year incidence of peripheral arterial disease (PAD) in a French population and assessed the association of glucose metabolism, smoking, cardiovascular risk factors and physical activity with incident PAD.
      Methods: Participants from the French Data from a Epidemiological Study on the Insulin Resistance Syndrome (DESIR) were studied. Participants analysed were 30-65 years (at baseline) and had complete data (n=3805) after 6 years of follow-up. Diabetes was diagnosed according to the 1999 WHO criteria on the basis of fasting plasma glucose results or previous diagnosis of diabetes mellitus. The ankle brachial pressure index (ABPI) and a claudication question were used to classify PAD.
      Results: The 6-year incidence of PAD (defined by ABPI<0.9 and or claudication present) among those with normal fasting glucose (NFG) and free of PAD at baseline was 5.1%. Among those with impaired fasting glucose (IFG) at baseline the incidence of PAD was 4.9% and among those with diabetes mellitus at baseline the incidence of PAD was 9.8%. The incidence of PAD among those who maintained NFG over 6 years was 4.7% and among those who progressed to diabetes over 6 years was 10.2%. Those who progressed from NFG or IFG to diabetes over 6 years were twice as likely to develop PAD compared to those who maintained NFG over 6 years, after adjustment for age and sex (OR (95% CI), 2.22 (1.12-4.42)). Independent risk factors for incident PAD using baseline population characteristics were diabetes (OR (95% CI) 2.11 (1.25-3.55)), systolic BP 122-135mmHg 1.06 (0.70-1.60), >135mmHg 1.54 (1.04-2.27) and current smoking 1.60 (1.10-2.34) after multivariate adjustment for age, sex, cholesterol, triglycerides and waist circumference.
      Conclusions: This French study shows that those who progress to diabetes are twice as likely to develop PAD, compared to those who maintain NFG. Peripheral arterial disease is a treatable condition and more aggressive management of atherosclerotic risk factors could reduce the numbers of people who develop PAD.
    • Accession Number:
      IY9XDZ35W2 (Glucose)
    • Publication Date:
      Date Created: 20060506 Date Completed: 20070321 Latest Revision: 20131121
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.atherosclerosis.2006.02.017
    • Accession Number:
      16674960