Pulse pressure and michigan neuropathy screening instrument are independently associated with asymptomatic peripheral arterial disease among type 2 diabetes community residents: A community-based screening program in Taiwan

• Main Authors: Li-Chi Fan, Mei-Yen Chen, Wei-Chao Huang, Cheng Ho, Pao-Yin Chen, Jui-Chu Huang, Hsu-Huei Weng, Yun-Shing Peng
• Format: Article
• Language: English
• Published: Elsevier 2013-12-01
• Series: Biomedical Journal
• Subjects: Asymptomatic; diabetes mellitus; Michigan Neuropathy Screening Instrument; peripheral arterial disease; pulse pressure
• Online Access: http://www.biomedj.org/article.asp?issn=2319-4170;year=2013;volume=36;issue=6;spage=282;epage=288;aulast=Fan
• ISSN: 2319-4170; 2320-2890

Background: Peripheral arterial disease (PAD) is one of the major manifestations of systemic atherosclerosis and plays an important role in low-extremity amputation in type 2 diabetic patients. The aim of this study was to explore the prevalence and risk factors for asymptomatic PAD in type 2 diabetic community residents. Methods: This cross-sectional study enrolled 552 type 2 diabetic adults (232 men and 320 women) without subjective symptoms of intermittent claudication. We defined the PAD group as an ankle-brachial index (ABI) ≤ 0.90, and the normal group as an ABI 0.91-1.30. Their clinical characteristics, Michigan Neuropathy Screening Instrument (MNSI) scores and blood pressure were compared. Results: We discovered that 51 patients have asymptomatic PAD. Univariate logistic regression analysis revealed that age, history of stroke, longer duration of diabetes (> 10 years), unemployment or retirement, pulse pressure, systolic blood pressure, and high MNSI score (> 2) were risk factors for PAD. By multivariate logistic regression analysis, pulse pressure, high MNSI score, age, and history of stroke were independent risk factors with odds ratios (95% confidence intervals, CI) of 1.032 (1.012-1.053), 2.359 (1.274-4.370), 1.050 (1.010-1.091), and 5.152 (1.985-13.368), respectively. Furthermore, the prevalence of PAD increased significantly with increment in the pulse pressure and MNSI. Conclusions: In summary, the overall prevalence of asymptomatic PAD in the type 2 diabetic adults was 9.2%. Age, history of stroke, pulse pressure and MNSI score may provide important clinical information. Primary care physicians should be aware of asymptomatic patients with high pulse pressure and MNSI scores.