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Association of glucose metabolism, smoking and cardiovascular risk factors with incident peripheral arterial disease : The DESIR study

Identifieur interne : 009714 ( Main/Exploration ); précédent : 009713; suivant : 009715

Association of glucose metabolism, smoking and cardiovascular risk factors with incident peripheral arterial disease : The DESIR study

Auteurs : Robyn J. Tapp [France, Australie] ; Beverley Balkau [France] ; Jonathan E. Shaw [Australie] ; Paul Valensi [France] ; Martine Cailleau [France] ; Eveline Eschwege [France]

Source :

RBID : Pascal:07-0335594

Descripteurs français

English descriptors

Abstract

Aims: We determined the 6-year incidence of peripheral arterial disease (PAD) in a French population and assessed the association of glucose metabolism, smoking, cardiovascular risk factors and physical activity with incident PAD. Methods: Participants from the French Data from a Epidemiological Study on the Insulin Resistance Syndrome (DESIR) were studied. Participants analysed were 30-65 years (at baseline) and had complete data (n = 3805) after 6 years of follow-up. Diabetes was diagnosed according to the 1999 WHO criteria on the basis of fasting plasma glucose results or previous diagnosis of diabetes mellitus. The ankle brachial pressure index (ABPI) and a claudication question were used to classify PAD. Results: The 6-year incidence of PAD (defined by ABPI < 0.9 and or claudication present) among those with normal fasting glucose (NFG) and free of PAD at baseline was 5.1%. Among those with impaired fasting glucose (IFG) at baseline the incidence of PAD was 4.9% and among those with diabetes mellitus at baseline the incidence of PAD was 9.8%. The incidence of PAD among those who maintained NFG over 6 years was 4.7% and among those who progressed to diabetes over 6 years was 10.2%. Those who progressed from NFG or IFG to diabetes over 6 years were twice as likely to develop PAD compared to those who maintained NFG over 6 years, after adjustment for age and sex (OR (95% CI), 2.22 (1.12-4.42)). Independent risk factors for incident PAD using baseline population characteristics were diabetes (OR (95% CI) 2.11 (1.25-3.55)), systolic BP 122-135 mmHg 1.06 (0.70-1.60), >135mmHg 1.54 (1.04-2.27) and current smoking 1.60 (1.10-2.34) after multivariate adjustment for age, sex, cholesterol, triglycerides and waist circumference. Conclusions: This French study shows that those who progress to diabetes are twice as likely to develop PAD, compared to those who maintain NFG. Peripheral arterial disease is a treatable condition and more aggressive management of atherosclerotic risk factors could reduce the numbers of people who develop PAD.


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Le document en format XML

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<term>Intolérance au glucose (épidémiologie)</term>
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<term>Maladies vasculaires périphériques (épidémiologie)</term>
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<term>France</term>
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<term>Diabetes Mellitus, Type 2</term>
<term>Glucose Intolerance</term>
<term>Peripheral Vascular Diseases</term>
<term>Smoking</term>
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<term>Diabetes Mellitus, Type 2</term>
<term>Glucose Intolerance</term>
<term>Peripheral Vascular Diseases</term>
<term>Smoking</term>
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<term>Diabète de type 2</term>
<term>Glucose</term>
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<term>Diabète de type 2</term>
<term>France</term>
<term>Intolérance au glucose</term>
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<term>Tabagisme</term>
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<term>Adult</term>
<term>Aged</term>
<term>Disease Progression</term>
<term>Female</term>
<term>Humans</term>
<term>Incidence</term>
<term>Insulin Resistance</term>
<term>Logistic Models</term>
<term>Longitudinal Studies</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Risk Factors</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Appareil circulatoire pathologie</term>
<term>Athérosclérose</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Incidence</term>
<term>Insulinorésistance</term>
<term>Modèles logistiques</term>
<term>Mâle</term>
<term>Sujet âgé</term>
<term>Tabagisme</term>
<term>Artériopathie oblitérante</term>
<term>Diabète</term>
<term>Glucose</term>
<term>Métabolisme</term>
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<term>Incidence</term>
<term>Epidémiologie</term>
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<term>Claudication</term>
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<term>Triglycéride</term>
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<term>Évolution de la maladie</term>
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<term>France</term>
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<front>
<div type="abstract" xml:lang="en">Aims: We determined the 6-year incidence of peripheral arterial disease (PAD) in a French population and assessed the association of glucose metabolism, smoking, cardiovascular risk factors and physical activity with incident PAD. Methods: Participants from the French Data from a Epidemiological Study on the Insulin Resistance Syndrome (DESIR) were studied. Participants analysed were 30-65 years (at baseline) and had complete data (n = 3805) after 6 years of follow-up. Diabetes was diagnosed according to the 1999 WHO criteria on the basis of fasting plasma glucose results or previous diagnosis of diabetes mellitus. The ankle brachial pressure index (ABPI) and a claudication question were used to classify PAD. Results: The 6-year incidence of PAD (defined by ABPI < 0.9 and or claudication present) among those with normal fasting glucose (NFG) and free of PAD at baseline was 5.1%. Among those with impaired fasting glucose (IFG) at baseline the incidence of PAD was 4.9% and among those with diabetes mellitus at baseline the incidence of PAD was 9.8%. The incidence of PAD among those who maintained NFG over 6 years was 4.7% and among those who progressed to diabetes over 6 years was 10.2%. Those who progressed from NFG or IFG to diabetes over 6 years were twice as likely to develop PAD compared to those who maintained NFG over 6 years, after adjustment for age and sex (OR (95% CI), 2.22 (1.12-4.42)). Independent risk factors for incident PAD using baseline population characteristics were diabetes (OR (95% CI) 2.11 (1.25-3.55)), systolic BP 122-135 mmHg 1.06 (0.70-1.60), >135mmHg 1.54 (1.04-2.27) and current smoking 1.60 (1.10-2.34) after multivariate adjustment for age, sex, cholesterol, triglycerides and waist circumference. Conclusions: This French study shows that those who progress to diabetes are twice as likely to develop PAD, compared to those who maintain NFG. Peripheral arterial disease is a treatable condition and more aggressive management of atherosclerotic risk factors could reduce the numbers of people who develop PAD.</div>
</front>
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