Serum sialic acid and ankle versus brachial arterial-pressure ratio in NIDDM.

Serum sialic acid is related to mortality from cardiovascular disease and is increased in patients with diabetic microangiopathies. The purpose of this study was to examine whether serum sialic acid is associated with ischemic disease of the lower extremities, using the ankle versus brachial arterial-pressure ratio. The subjects were NIDDM patients attending diabetic clinics. They received a questionnaire on smoking and duration of diabetes, and physical examinations including measurement of blood pressure of upper and lower extremities. Fasting blood was taken for measurement of sialic acid, total and HDL cholesterol, and HbA1c. Serum sialic acid was significantly correlated with ankle versus brachial arterial-pressure ratio (r = -0.32) and HbA1c (r=0.45). The correlation with ankle versus brachial arterial-pressure ratio was evident in the patients with low ankle versus brachial arterial-pressure ratios (r = -0.66), but was not significant in those with normal ankle versus brachial arterial-pressure ratios (r=0.16). The correlation with HbA1c was significant independently of ankle versus brachial arterial-pressure ratios. Mean serum sialic acid was higher in patients with very low ankle versus brachial arterial-pressure ratios (< 0.9) than in those with normal ankle versus brachial arterial-pressure ratios (> or = 1.0) or slightly low ankle versus brachial arterial-pressure ratios (0.9 approximately 1.0). These results suggest that serum sialic acid reflects the status of blood glucose control and the progression of ischemic disease of the lower extremities in NIDDM patients.