High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.

Little is known about the relationship between lower extremity peripheral arterial disease (PAD) and proliferative diabetic retinopathy (PDR) in type 2 diabetes (T2D). Here, we explored the relationship between sight-threatening PDR and PAD. We screened for diabetic retinopathy (DR) and PAD in hospi...

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Main Authors: Yi-Wen Chen, Ying-Ying Wang, Dong Zhao, Cai-Guo Yu, Zhong Xin, Xi Cao, Jing Shi, Guang-Ran Yang, Ming-Xia Yuan, Jin-Kui Yang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4379174?pdf=render
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author Yi-Wen Chen
Ying-Ying Wang
Dong Zhao
Cai-Guo Yu
Zhong Xin
Xi Cao
Jing Shi
Guang-Ran Yang
Ming-Xia Yuan
Jin-Kui Yang
author_facet Yi-Wen Chen
Ying-Ying Wang
Dong Zhao
Cai-Guo Yu
Zhong Xin
Xi Cao
Jing Shi
Guang-Ran Yang
Ming-Xia Yuan
Jin-Kui Yang
author_sort Yi-Wen Chen
collection DOAJ
description Little is known about the relationship between lower extremity peripheral arterial disease (PAD) and proliferative diabetic retinopathy (PDR) in type 2 diabetes (T2D). Here, we explored the relationship between sight-threatening PDR and PAD. We screened for diabetic retinopathy (DR) and PAD in hospitalized patients with T2D. Patients with a diabetic duration of more than 10 years, HbA1c ≥7.5%, eGFR ≥60 mL/min/1.73 m2 and with PDR or with no diabetic retinopathy (NDR) were eligible for this cross-sectional study. Severities of DR were graded by digital retinal photographs according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. We assessed PAD by measuring Ankle Brachial Index (ABI), Toe Brachial Index (TBI) and Doppler ultrasound. Statistical analyses were performed using SPSS 17.0 software. Of the 1544 patients, 169 patients with extreme eye (57 PDR and 112 NDR) phenotypes met the inclusion criteria. Patients with PDR had a significantly higher proportion of low ABI (≤0.99) and high ABI (≥1.3) than patients with NDR (28.1% and 15.8% vs. 14.3% and 6.2% respectively, P<0.05). PDR patients also had lower TBI than NDR patients (0.56±0.09 vs. 0.61±0.08, P<0.01). The proportion of patients with abnormal duplex ultrasound was higher in PDR than in NDR (21.1% vs. 9.8%, P<0.001). This showed that PDR associated with PAD could be defined in multiple ways: abnormal ABI (≤0.9) (OR = 3.61, 95% CI: 1.15-11.26), abnormal TBI (OR = 2.84, 95% CI: 1.19-6.64), abnormal duplex (OR = 3.28, 95% CI: 1.00-10.71), and critical limb ischemia (OR = 5.52, 95% CI: 2.14-14.26). Moreover, PDR was a stronger independent correlation factor for PAD than a diabetic duration of 10 years. In conclusion, PAD is more common in PDR than in NDR. It implies that PDR and PAD are mostly concomitant in T2D. We should focus on screening PAD in patients with PDR in clinical practice.
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spelling doaj.art-52b9a0e5342e4fd2b48df5ff8a017fe42022-12-22T00:54:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01103e012202210.1371/journal.pone.0122022High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.Yi-Wen ChenYing-Ying WangDong ZhaoCai-Guo YuZhong XinXi CaoJing ShiGuang-Ran YangMing-Xia YuanJin-Kui YangLittle is known about the relationship between lower extremity peripheral arterial disease (PAD) and proliferative diabetic retinopathy (PDR) in type 2 diabetes (T2D). Here, we explored the relationship between sight-threatening PDR and PAD. We screened for diabetic retinopathy (DR) and PAD in hospitalized patients with T2D. Patients with a diabetic duration of more than 10 years, HbA1c ≥7.5%, eGFR ≥60 mL/min/1.73 m2 and with PDR or with no diabetic retinopathy (NDR) were eligible for this cross-sectional study. Severities of DR were graded by digital retinal photographs according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. We assessed PAD by measuring Ankle Brachial Index (ABI), Toe Brachial Index (TBI) and Doppler ultrasound. Statistical analyses were performed using SPSS 17.0 software. Of the 1544 patients, 169 patients with extreme eye (57 PDR and 112 NDR) phenotypes met the inclusion criteria. Patients with PDR had a significantly higher proportion of low ABI (≤0.99) and high ABI (≥1.3) than patients with NDR (28.1% and 15.8% vs. 14.3% and 6.2% respectively, P<0.05). PDR patients also had lower TBI than NDR patients (0.56±0.09 vs. 0.61±0.08, P<0.01). The proportion of patients with abnormal duplex ultrasound was higher in PDR than in NDR (21.1% vs. 9.8%, P<0.001). This showed that PDR associated with PAD could be defined in multiple ways: abnormal ABI (≤0.9) (OR = 3.61, 95% CI: 1.15-11.26), abnormal TBI (OR = 2.84, 95% CI: 1.19-6.64), abnormal duplex (OR = 3.28, 95% CI: 1.00-10.71), and critical limb ischemia (OR = 5.52, 95% CI: 2.14-14.26). Moreover, PDR was a stronger independent correlation factor for PAD than a diabetic duration of 10 years. In conclusion, PAD is more common in PDR than in NDR. It implies that PDR and PAD are mostly concomitant in T2D. We should focus on screening PAD in patients with PDR in clinical practice.http://europepmc.org/articles/PMC4379174?pdf=render
spellingShingle Yi-Wen Chen
Ying-Ying Wang
Dong Zhao
Cai-Guo Yu
Zhong Xin
Xi Cao
Jing Shi
Guang-Ran Yang
Ming-Xia Yuan
Jin-Kui Yang
High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.
PLoS ONE
title High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.
title_full High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.
title_fullStr High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.
title_full_unstemmed High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.
title_short High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.
title_sort high prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy
url http://europepmc.org/articles/PMC4379174?pdf=render
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