AIMS: To determine the relationship between foot ulcers, arterial calcification, and peripheral occlusive disease in patients with type 2 diabetes. METHODS: We performed a cross-sectional study on 162 patients with type 2 diabetes who underwent assessment of tibial artery calcification (TAC) by non-contrasted CT scan. Peripheral artery occlusive disease was assessed by angiography. Foot status including the presence or absence of ulcers was documented at presentation. A multivariable logistic regression model was used to evaluate the association between foot ulcers, arterial calcification, and the extent of peripheral atherosclerotic occlusive disease. RESULTS: Patients with foot ulcers (N=31) were more likely to be older and have a history of tobacco use. They were also more likely to have higher TAC scores (median [IQR]: 4324.6 [609.9, 11163.6] vs. 9.4 [0.0, 343.9], P<0.001) and more advanced peripheral artery occlusive disease (occlusion index 5.5 [4.8, 6.4] vs. 2.2 [1.0, 3.6], P<0.001). Foot ulcer was strongly associated with elevated TAC scores in a multivariable regression model (odds ratio [95% CI]=2.76 [1.61, 4.75], P=0.0002). CONCLUSIONS: There is a strong association between arterial calcification and diabetic foot ulcers that persists after adjusting for the extent of atherosclerosis in patients with type 2 diabetes.
AIMS: To determine the relationship between foot ulcers, arterial calcification, and peripheral occlusive disease in patients with type 2 diabetes. METHODS: We performed a cross-sectional study on 162 patients with type 2 diabetes who underwent assessment of tibial artery calcification (TAC) by non-contrasted CT scan. Peripheral artery occlusive disease was assessed by angiography. Foot status including the presence or absence of ulcers was documented at presentation. A multivariable logistic regression model was used to evaluate the association between foot ulcers, arterial calcification, and the extent of peripheral atherosclerotic occlusive disease. RESULTS:Patients with foot ulcers (N=31) were more likely to be older and have a history of tobacco use. They were also more likely to have higher TAC scores (median [IQR]: 4324.6 [609.9, 11163.6] vs. 9.4 [0.0, 343.9], P<0.001) and more advanced peripheral artery occlusive disease (occlusion index 5.5 [4.8, 6.4] vs. 2.2 [1.0, 3.6], P<0.001). Foot ulcer was strongly associated with elevated TAC scores in a multivariable regression model (odds ratio [95% CI]=2.76 [1.61, 4.75], P=0.0002). CONCLUSIONS: There is a strong association between arterial calcification and diabetic foot ulcers that persists after adjusting for the extent of atherosclerosis in patients with type 2 diabetes.
Authors: Anne L Carrington; Jonathan E Shaw; Carine H M Van Schie; Caroline A Abbott; Loretta Vileikyte; Andrew J M Boulton Journal: Diabetes Care Date: 2002-11 Impact factor: 19.112
Authors: G E Reiber; L Vileikyte; E J Boyko; M del Aguila; D G Smith; L A Lavery; A J Boulton Journal: Diabetes Care Date: 1999-01 Impact factor: 19.112
Authors: G Sangiorgi; J A Rumberger; A Severson; W D Edwards; J Gregoire; L A Fitzpatrick; R S Schwartz Journal: J Am Coll Cardiol Date: 1998-01 Impact factor: 24.094
Authors: Kathleen M Hill Gallant; Connie M Weaver; Dwight A Towler; Sowmyanarayanan V Thuppal; Regan L Bailey Journal: Adv Nutr Date: 2016-05-16 Impact factor: 8.701