Identification of peripheral arterial disease in diabetic patients and its association with quality of life, physical activity and body composition

BACKGROUND: Diabetes mellitus (DM) is a risk factor for peripheral arterial disease (PAD). Neither the prevalence of PAD in type 2 (T2) DM nor its detrimental effects on quality of life (QoL) or physical activity (PA) have been well described in the Brazilian population. OBJECTIVES: To evaluate the prevalence of newly diagnosed PAD and its associations with QoL, PA and body composition in a sample of T2DM patients from a University Hospital. METHODS: Seventy-three (73) T2DM patients without previous diagnoses of major complications related to T2DM were enrolled. PAD was assessed using the ankle-brachial index (ABI); QoL was measured using a translated and validated SF-36 questionnaire; PA was measured using a modified Baecke questionnaire; and body composition was measured by segmental multi-frequency bioelectrical impedance. RESULTS: PAD prevalence was 13.7%, predominantly of mild severity (ABI between 0.8-0.9). The ABI results correlated with age (ρ=-0.26, P=0.03), DM duration (ρ=-0.28, P=0.02) and systolic and diastolic blood pressure (ρ=-0.33, P=0.007 and ρ=-0.28, P=0.02; respectively). Scores for the SF-36 physical component summary (PCS) were below the normal range, but no negative impact from PAD was identified by the PCS scores (normal-ABI 42.9±11.2 vs. PAD-ABI 38.12±11.07) or the Baecke PA results. Body composition analysis detected excessive body fat, especially in women, but there was no difference between groups. CONCLUSIONS: The prevalence of previously undiagnosed PAD in this population of T2DM patients was 13.7%, predominantly mild and asymptomatic forms, and was not yet associated with worsened QoL, PA levels or body composition variables.背景：糖尿病（Diabetes mellitus, DM）是外周动脉疾病（peripheral arterial disease, PAD）的危险因素。目前针对巴西人群的相关研究中，尚未充分阐明2型糖尿病（type 2 diabetes, T2DM）患者的PAD患病率，以及PAD对其生活质量（quality of life, QoL）或体力活动（physical activity, PA）的不良影响。 研究目标：评估某大学医院收治的2型糖尿病患者队列中新诊断PAD的患病率，并分析其与生活质量、体力活动及身体成分的关联。 研究方法：纳入73例既往未被诊断存在2型糖尿病相关主要并发症的2型糖尿病患者。采用踝肱指数（ankle-brachial index, ABI）评估PAD；采用经翻译并验证的SF-36量表评估生活质量；采用改良Baecke问卷评估体力活动；采用节段性多频生物电阻抗分析法测量身体成分。 研究结果：本队列中PAD患病率为13.7%，以轻度病变为主（ABI值介于0.8~0.9之间）。ABI结果与年龄（ρ=-0.26，P=0.03）、糖尿病病程（ρ=-0.28，P=0.02）及收缩压、舒张压（分别为ρ=-0.33，P=0.007；ρ=-0.28，P=0.02）呈显著负相关。SF-36量表的躯体健康总评（physical component summary, PCS）得分低于正常参考范围，但无论是PCS得分（正常ABI组：42.9±11.2；PAD组：38.12±11.07）还是改良Baecke问卷的体力活动评估结果，均未发现PAD带来的负面影响。身体成分分析显示受试者存在体脂过量的情况，尤以女性群体为著，但两组间未观察到显著差异。 研究结论：本研究纳入的2型糖尿病患者队列中，既往未被诊断的PAD患病率为13.7%，病变以轻度、无症状型为主，且尚未与生活质量下降、体力活动水平降低及身体成分指标异常存在关联。