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Peripheral artery disease and exertional leg symptoms in diabetes patients in Ghana.

Yeboah K, Puplampu P, Ainuson J, Akpalu J, Gyan B, Amoah AG - BMC Cardiovasc Disord (2016)

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Accra, Ghana. melvinky@gmail.com.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Flow chart of subjects’ recruitment
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Fig1: Flow chart of subjects’ recruitment

Mentions: The study was case control design National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital in Accra, Ghana, from June 2009 to May 2010. The centre is Ghana’s main referral clinic and operates ambulatory diabetes services and research. The cases were already diagnosed DM patients, recruited by systematic sampling, as every 3rd patient vising the centre. The controls were recruited afterwards and matched with the cases by gender and age-decade. The controls were non-diabetes volunteers, with normal fasting glucose (<6.9 mmol/l) and post-glucose load plasma glucose (<7.2 mmol/l), recruited by invitation from the communities around the hospitals. Out of 1000 volunteers (600 DM and 400 non-diabetes) invited, 866 (516 DM and 350 non-diabetes) consented to participate in the study. In the final analysis, 31 diabetes (11 refused consent and 20 had incomplete ABI measurement) and 20 non-diabetes participants (9 had impaired glucose metabolism and 11 had incomplete ABI) were excluded (Fig. 1). Ethical approval for this study was obtained from the University of Ghana Medical School Ethical and Protocol Review Committee (Protocol ID number: MS-Et/M.2 – P.4.10/2009-2010) and all participants gave written informed consent after the procedures involved in the study were thoroughly explained to them.Fig. 1


Peripheral artery disease and exertional leg symptoms in diabetes patients in Ghana.

Yeboah K, Puplampu P, Ainuson J, Akpalu J, Gyan B, Amoah AG - BMC Cardiovasc Disord (2016)

Flow chart of subjects’ recruitment
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837554&req=5

Fig1: Flow chart of subjects’ recruitment
Mentions: The study was case control design National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital in Accra, Ghana, from June 2009 to May 2010. The centre is Ghana’s main referral clinic and operates ambulatory diabetes services and research. The cases were already diagnosed DM patients, recruited by systematic sampling, as every 3rd patient vising the centre. The controls were recruited afterwards and matched with the cases by gender and age-decade. The controls were non-diabetes volunteers, with normal fasting glucose (<6.9 mmol/l) and post-glucose load plasma glucose (<7.2 mmol/l), recruited by invitation from the communities around the hospitals. Out of 1000 volunteers (600 DM and 400 non-diabetes) invited, 866 (516 DM and 350 non-diabetes) consented to participate in the study. In the final analysis, 31 diabetes (11 refused consent and 20 had incomplete ABI measurement) and 20 non-diabetes participants (9 had impaired glucose metabolism and 11 had incomplete ABI) were excluded (Fig. 1). Ethical approval for this study was obtained from the University of Ghana Medical School Ethical and Protocol Review Committee (Protocol ID number: MS-Et/M.2 – P.4.10/2009-2010) and all participants gave written informed consent after the procedures involved in the study were thoroughly explained to them.Fig. 1

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Accra, Ghana. melvinky@gmail.com.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus