Correlates and predictors of peripheral artery disease in patients with type 2 diabetes mellitus in Calabar, Nigeria: a multicentre cross-sectional comparative study.

Abstract

Background: Peripheral arterial disease is a major macrovascular complication of diabetes mellitus. We aimed to determine the prevalence of peripheral artery disease among patients with type 2 diabetes mellitus in Calabar and its correlation with traditional risk factors such as hypertension, dyslipidaemia, age, smoking, glycaemic control and inflammatory markers such as high-sensitivity C-reactive protein and fibrinogen.

Materials and methods: This was a hospital-based multi-centre cross-sectional comparative study. A proportionate stratified sampling technique was used to determine the number of diabetics recruited from the diabetes centre of the University of Calabar Teaching Hospital, Nigerian Navy Reference Hospital and General Hospital Calabar. Peripheral artery disease was defined as ankle brachial index value of < 0.9 in at least one limb and was measured using a handheld Doppler (8 MHz Life Dop Summit device).

Results: The prevalence of peripheral artery disease using ABI < 0.9 in this study was 37.5% in people living with type 2 diabetes and 8.0% in controls. A statistically significant relationship was observed between advanced age (p = 0.003), hypertension (p = 0.03), duration of diabetes (p < 0.001), glycaemic control (p < 0.001), fibrinogen (p < 0.001) as well as C-reactive protein (p < 0.001), and peripheral artery disease among people living with Type 2 diabetes. After multiple regression analysis, the predictors of peripheral artery disease in this study were duration of diabetes and elevated serum C-reactive protein. There was no significant association between smoking, obesity and lipid profiles with peripheral artery disease.

Conclusion: There is a high prevalence of peripheral artery disease among Type 2 diabetics in our setting. Besides the traditional risk factors such as advancing age, hypertension and duration of diabetes, which are known to be associated with peripheral artery disease in diabetics, we identified fibrinogen and C-reactive protein as inflammatory markers which could enhance the early detection of peripheral artery disease in Type 2 diabetics.