Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/1677-5449.202400852
Jornal Vascular Brasileiro
Original Article

Prevalence of peripheral arterial disease and its association with claudication in individuals with type 2 Diabetes Mellitus: a prospective cross-sectional study in Brazil

Prevalência de doença arterial periférica e sua associação com a claudicação em indivíduos com Diabetes Mellitus tipo 2: um estudo transversal prospectivo brasileiro

Gislaine Bonete da Cruz; Cibele Teresinha Dias Ribeiro; Camila Maciel de Oliveira; Rosangela Roginski Rea; Fernando Augusto Lavezzo Dias

http://dx.doi.org/10.1590/1677-5449.202400852 J Vasc Bras, vol.24, e20240085, 2025
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Abstract

Background: Few studies have described the prevalence of peripheral arterial disease (PAD) in the diabetic population of Brazil.

Objectives: To evaluate the prevalence of PAD and its association with the presence of claudication and to compare risk factors for atherosclerosis between subjects with and without PAD.

Methods: An analytical, observational, prospective, cross-sectional study was conducted with 150 volunteers with type 2 Diabetes Mellitus (T2DM) treated at a university endocrinology outpatient clinic (Federal University of Paraná, Curitiba, Brazil) and assessed using the ankle-brachial index (ABI) and the Edinburgh Claudication Questionnaire.

Results: ABI was evaluated in 143 volunteers (7 did not meet the inclusion criteria). Six individuals had an ABI > 1.4. Excluding these cases and adopting an ABI ≤ 0.9 to identify PAD, the prevalence of PAD was 14.6% (20 of 137), 15.8% in men (6 of 38), and 14.1% in women (14 of 99). We identified twenty-five participants with borderline ABI (18.2%). Claudication was present in 25% of subjects with PAD; however, only 15% had typical claudication. A significant association with the presence of typical claudication was observed only when ABI values were stratified above or below 1.0 (p = 0.04, Fisher’s exact test). Participants with PAD were older (median difference: 5.5 years, 95% CI 3.0 to 9.0, p < 0.001) and tended to have a longer duration of DM and higher BMI.

Conclusions: The prevalence of PAD in T2DM volunteers with no prior screening was 14.6% and 75% were asymptomatic.

Keywords

peripheral arterial disease; Diabetes Mellitus; diabetes complications; prevalence; ankle-brachial index

Resumo

Contexto: Há poucos estudos que descrevem a prevalência da doença arterial periférica (DAP) na população diabética no Brasil.

Objetivos: Avaliar a prevalência de DAP e sua associação com a presença de claudicação e comparar fatores de risco para aterosclerose entre indivíduos com e sem DAP.

Métodos: Estudo analítico, observacional, prospectivo e transversal, realizado com 150 voluntários com Diabetes Mellitus tipo 2 (DM2) em tratamento no ambulatório universitário de endocrinologia da Universidade Federal do Paraná (Curitiba, Brasil). Os participantes foram avaliados pelo índice tornozelo-braquial (ITB) e pelo Questionário de Claudicação de Edinburgh.

Resultados: O ITB foi avaliado em 143 voluntários (7 não atenderam aos critérios de inclusão). Seis indivíduos apresentaram ITB > 1,4. Excluindo esses casos e adotando o ITB ≤ 0,9 para a definição de DAP, a prevalência da doença foi de 14,6% (20 de 137), sendo 15,8% em homens (6 de 38) e 14,1% em mulheres (14 em 99). Além disso, 25 participantes apresentaram ITB limítrofe (18,2%). A claudicação esteve presente em 25% dos indivíduos com DAP, mas apenas 15% apresentaram claudicação típica. A associação entre DAP e claudicação típica foi significativa apenas quando os grupos foram estratificados para valores de ITB acima ou abaixo que 1,0 (p = 0,04, teste exato de Fisher). Os participantes com DAP eram mais velhos (diferença de medianas: 5,5 anos; intervalo de confiança de 95% de 3,0-9,0; p < 0,001) e apresentaram tendência a maior duração do DM e maior índice de massa corporal.

Conclusões: A prevalência de DAP em indivíduos com DM2, sem triagem prévia, foi de 14,6%, sendo 75% assintomáticos.

Palavras-chave

doença arterial periférica; Diabetes Mellitus; complicações do diabetes; prevalência; índice tornozelo-braço

References

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Submitted date:
06/21/2024

Accepted date:
02/20/2025

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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