Association of glucose metabolism, smoking and cardiovascular risk factors with incident peripheral arterial disease : The DESIR study
Identifieur interne : 00A159 ( Main/Merge ); précédent : 00A158; suivant : 00A160Association 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 :
- Atherosclerosis [ 0021-9150 ] ; 2007.
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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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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Association of glucose metabolism, smoking and cardiovascular risk factors with incident peripheral arterial disease : The DESIR study</title>
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<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Epidemiology and Preventive Medicine, Monash University</s1>
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<author><name sortKey="Balkau, Beverley" sort="Balkau, Beverley" uniqKey="Balkau B" first="Beverley" last="Balkau">Beverley Balkau</name>
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<author><name sortKey="Valensi, Paul" sort="Valensi, Paul" uniqKey="Valensi P" first="Paul" last="Valensi">Paul Valensi</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Endocrinology, Diabetology and Nutrition, Jean Verdier Hospital, Paris-Nord University</s1>
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<country>France</country>
<wicri:noRegion>Paris-Nord University</wicri:noRegion>
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<author><name sortKey="Cailleau, Martine" sort="Cailleau, Martine" uniqKey="Cailleau M" first="Martine" last="Cailleau">Martine Cailleau</name>
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<s2>La Riche</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
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<country>France</country>
<wicri:noRegion>La Riche</wicri:noRegion>
<wicri:noRegion>IRSA</wicri:noRegion>
<wicri:noRegion>IRSA</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Eschwege, Eveline" sort="Eschwege, Eveline" uniqKey="Eschwege E" first="Eveline" last="Eschwege">Eveline Eschwege</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>INSERM Unite 258-IFR69, University Paris XI</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
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<sZ>2 aut.</sZ>
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<country>France</country>
<wicri:noRegion>Villejuif</wicri:noRegion>
<wicri:noRegion>University Paris XI</wicri:noRegion>
<wicri:noRegion>Villejuif</wicri:noRegion>
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<series><title level="j" type="main">Atherosclerosis</title>
<title level="j" type="abbreviated">Atherosclerosis</title>
<idno type="ISSN">0021-9150</idno>
<imprint><date when="2007">2007</date>
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</series>
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<seriesStmt><title level="j" type="main">Atherosclerosis</title>
<title level="j" type="abbreviated">Atherosclerosis</title>
<idno type="ISSN">0021-9150</idno>
</seriesStmt>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Atherosclerosis</term>
<term>Cardiovascular disease</term>
<term>Cholesterol</term>
<term>Claudication</term>
<term>Clinical management</term>
<term>Diabetes mellitus</term>
<term>Diagnosis</term>
<term>Epidemiology</term>
<term>Fasting</term>
<term>Glucose</term>
<term>Incidence</term>
<term>Insulin</term>
<term>Metabolism</term>
<term>Occlusive arterial disease</term>
<term>Risk factor</term>
<term>Tobacco smoking</term>
<term>Triglyceride</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Appareil circulatoire pathologie</term>
<term>Athérosclérose</term>
<term>Tabagisme</term>
<term>Artériopathie oblitérante</term>
<term>Diabète</term>
<term>Glucose</term>
<term>Métabolisme</term>
<term>Facteur risque</term>
<term>Incidence</term>
<term>Epidémiologie</term>
<term>Insuline</term>
<term>Jeûne alimentaire</term>
<term>Diagnostic</term>
<term>Claudication</term>
<term>Cholestérol</term>
<term>Triglycéride</term>
<term>Conduite à tenir</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Tabagisme</term>
<term>Diabète</term>
<term>Glucose</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>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>France</li>
</country>
<region><li>Victoria (État)</li>
</region>
<settlement><li>Melbourne</li>
</settlement>
</list>
<tree><country name="France"><noRegion><name sortKey="Tapp, Robyn J" sort="Tapp, Robyn J" uniqKey="Tapp R" first="Robyn J." last="Tapp">Robyn J. Tapp</name>
</noRegion>
<name sortKey="Balkau, Beverley" sort="Balkau, Beverley" uniqKey="Balkau B" first="Beverley" last="Balkau">Beverley Balkau</name>
<name sortKey="Cailleau, Martine" sort="Cailleau, Martine" uniqKey="Cailleau M" first="Martine" last="Cailleau">Martine Cailleau</name>
<name sortKey="Eschwege, Eveline" sort="Eschwege, Eveline" uniqKey="Eschwege E" first="Eveline" last="Eschwege">Eveline Eschwege</name>
<name sortKey="Valensi, Paul" sort="Valensi, Paul" uniqKey="Valensi P" first="Paul" last="Valensi">Paul Valensi</name>
</country>
<country name="Australie"><noRegion><name sortKey="Tapp, Robyn J" sort="Tapp, Robyn J" uniqKey="Tapp R" first="Robyn J." last="Tapp">Robyn J. Tapp</name>
</noRegion>
<name sortKey="Shaw, Jonathan E" sort="Shaw, Jonathan E" uniqKey="Shaw J" first="Jonathan E." last="Shaw">Jonathan E. Shaw</name>
<name sortKey="Shaw, Jonathan E" sort="Shaw, Jonathan E" uniqKey="Shaw J" first="Jonathan E." last="Shaw">Jonathan E. Shaw</name>
</country>
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</record>
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