Abstract

Objectives: The main aim of the study was to find the association between obesity and other anthropometric indices with symptomatic peripheral arterial disease (PAD) in type 2 diabetes mellitus (T2DM) patients. Furthermore, we investigated other risk factors of symptomatic PAD in T2DM.

Study Design: In a case-control design, 46 cases and 69 controls were enrolled, aged between 40 and 75 years. Cases were age and gender matched with controls. Ankle-brachial index (ABI) <0.9 was a proxy for PAD in T2DM patients. Anthropometric indices were measured and known cardiovascular risk factors were collected, area under curve (AUC) and logistic regression were applied.

Results: Hypertensive patients had 2.5 fold higher risk of symptomatic PAD than normotensive patients, (CI 95%=1.16-5.51). Smoking habit was remarkably higher in cases than controls, OR=8.2 CI 95% (3.2-8.2), however this was not significant in smoking subgroups based on duration of smoking (pack-year). Waste hip ratio (WHR) ≥1 in both male and female was significantly related to the outcome, Odds ratio 3.12 (CI 95% 1.25-7.82) in men and of 26.67 (CI 95% 3.77-188.51) in women. In the final model (forward stepwise regression), WHR ≥ 1, hypertension, duration of DM and Smoking were significantly related to symptomatic PAD.

Conclusion: As obese patients are more prone to type 2 diabetes mellitus, the previous cut-offs of obesity may change in the future to assess the risk of CVD in this group. We suggest that WHR is a simple measure of abdominal obesity and is related to symptomatic PAD.