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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

a Age- and gender-adjusted prevalence of exertional leg pain in diabetes patients by PAD status. b Age- and gender-adjusted prevalence of exertional leg pain in non-diabetes participants by PAD status
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Fig2: a Age- and gender-adjusted prevalence of exertional leg pain in diabetes patients by PAD status. b Age- and gender-adjusted prevalence of exertional leg pain in non-diabetes participants by PAD status

Mentions: DM patients were older, with higher rate of hypertension and alcohol intake than non-diabetes controls. Also, DM patients has higher mean levels of BMI, heart rate, systolic, diastolic, mean and pulse blood pressures. The overall prevalence of ABI-diagnosed PAD was 26.7 %, with 6 % of the participants having stiff, partially incompressible artery (ABI > 1.3); more in DM patients (5.1 % vs. 0.9 %, p < 0.001) than non-diabetes participants. ABI categorization was associated with DM status, yet no difference in the mean ABI was observed between DM and non-diabetes controls (Table 1). Exertional leg symptoms were associated with DM status, with diabetes patients having higher age and gender adjusted prevalence of classical intermittent claudication (6.6 % vs 3.6 %, p < 0.05) and pain at rest (8.1 % vs 1.7 %, p < 0.01), but less atypical exertional pain (0.9 % vs 2.7 %, p < 0.01), than non-diabetes patients. In diabetes patients, age and gender adjusted prevalence of exertional leg symptoms were similar between PAD and non-PAD participants (Fig. 2a). However, in non-diabetes participants, PAD patients had higher age and gender adjusted prevalence of intermittent claudication and pain at rest tahn non-PAD participants (Fig. 2b). In all participants, 3.5 % had both PAD and classical intermittent claudication, higher in DM patients (2.6 % vs 0.9 %, p < 0.05) than non-diabetes participants. Compared to other leg symptoms groups, patients with intermittent claudication were older, with higher proportion of females, diabetes and hypertensive patients, and had higher systolic, diastolic and mean BPs (Additional file 2: Table S2).Table 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)

a Age- and gender-adjusted prevalence of exertional leg pain in diabetes patients by PAD status. b Age- and gender-adjusted prevalence of exertional leg pain in non-diabetes participants by PAD status
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: a Age- and gender-adjusted prevalence of exertional leg pain in diabetes patients by PAD status. b Age- and gender-adjusted prevalence of exertional leg pain in non-diabetes participants by PAD status
Mentions: DM patients were older, with higher rate of hypertension and alcohol intake than non-diabetes controls. Also, DM patients has higher mean levels of BMI, heart rate, systolic, diastolic, mean and pulse blood pressures. The overall prevalence of ABI-diagnosed PAD was 26.7 %, with 6 % of the participants having stiff, partially incompressible artery (ABI > 1.3); more in DM patients (5.1 % vs. 0.9 %, p < 0.001) than non-diabetes participants. ABI categorization was associated with DM status, yet no difference in the mean ABI was observed between DM and non-diabetes controls (Table 1). Exertional leg symptoms were associated with DM status, with diabetes patients having higher age and gender adjusted prevalence of classical intermittent claudication (6.6 % vs 3.6 %, p < 0.05) and pain at rest (8.1 % vs 1.7 %, p < 0.01), but less atypical exertional pain (0.9 % vs 2.7 %, p < 0.01), than non-diabetes patients. In diabetes patients, age and gender adjusted prevalence of exertional leg symptoms were similar between PAD and non-PAD participants (Fig. 2a). However, in non-diabetes participants, PAD patients had higher age and gender adjusted prevalence of intermittent claudication and pain at rest tahn non-PAD participants (Fig. 2b). In all participants, 3.5 % had both PAD and classical intermittent claudication, higher in DM patients (2.6 % vs 0.9 %, p < 0.05) than non-diabetes participants. Compared to other leg symptoms groups, patients with intermittent claudication were older, with higher proportion of females, diabetes and hypertensive patients, and had higher systolic, diastolic and mean BPs (Additional file 2: Table S2).Table 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