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Progression of Peripheral Occlusive Arterial Disease in Diabetes Mellitus: What Factors Are Predictive?

Progression of Peripheral Occlusive Arterial Disease in Diabetes Mellitus: What Factors Are... Abstract The clinical, biochemical, and vascular laboratory measurements potentially associated with the development and/or progression of peripheral occlusive arterial disease (POAD) were assessed during a 4-year period in 110 normal control subjects, 112 patients with POAD without diabetes mellitus, 240 patients with diabetes mellitus without POAD, and 100 patients with diabetes mellitus and POAD. Age, history of hypertension or coronary heart disease, history of cigarette smoking, presence of POAD, systolic blood pressure, and β-thromboglobulin level were associated with progression of POAD. A multivariate logistic regression model indicated that the presence of diabetes mellitus or POAD or both at baseline, decreased postexercise ankle-brachial index, increased arm systolic blood pressure, and current smoking were independently associated with progression of POAD. This study suggests that cessation of smoking and control of hypertension are essential treatment modifications to decrease the risk of progression of peripheral vascular disease in diabetic patients. (Arch Intern Med. 1991;151:717-721) References 1. Zimmerman BR, Palumbo PJ, O'Fallon WM, Osmundson PJ, Kazmier FJ. A prospective study of peripheral occlusive arterial disease in diabetes, I: clinical characteristics of the subjects . Mayo Clin Proc . 1981;56:217-222. 2. Osmundson PJ, Chesebro JH, O'Fallon WM, Zimmerman BR, Kazmier JF, Palumbo PJ. A prospective study of peripheral occlusive arterial disease in diabetes, II: vascular laboratory assessment . Mayo Clin Proc . 1981;56:223-232. 3. Zimmerman BR, Palumbo PJ, O'Fallon WM, Ellefson RD, Osmundson PJ, Kazmier FJ. A prospective study of peripheral occlusive arterial disease in diabetes, III: initial lipid and lipoprotein findings . Mayo Clin Proc . 1981;56:233-242. 4. Kazmier FJ, Bowie EJW, O'Fallon WM, Zimmerman BR, Osmundson PJ, Palumbo PJ. A prospective study of peripheral occlusive arterial disease in diabetes, IV: platelet and plasma functions . Mayo Clin Proc . 1981;56:243-253. 5. Osmundson PJ, O'Fallon WM, Zimmerman BR, Kazmier FJ, Langworthy AL, Palumbo PJ. Course of peripheral occlusive arterial disease in diabetes: vascular laboratory assessment . Diabetes Care . 1990;13:143-152.Crossref 6. Abraham EC, Huff TA, Cope ND, Wilson JB Jr, Bransome ED Jr, Huisman THJ. Determination of the glycosylated hemoglobins (Hb AI) with a new microcolumn procedure: suitability of the technique for assessing the clinical management of diabetes mellitus . Diabetes. 1978;27:931-937.Crossref 7. Beutler E. Red Cell Metabolism: A Manual of Biochemical Methods . New York, NY: Grune & Stratton; 1971. 8. Burrows AW, Chavin SI, Hockaday TDR. Plasma-thromboglobulin concentrations in diabetes mellitus . Lancet. 1978;1:235-237.Crossref 9. Fuster V, Kazmier FJ, Cash JD, Bowie EJW, Owen CA Jr. Assay of platelet factor 4 in plasma . Mayo Clin Proc. 1973;48:103-106. 10. Green MS. Evaluating the discriminatory power of a multiple logistic regression model . Stat Med. 1988;7:519-524.Crossref 11. Colwell JA, Bingham SF, Abraira C, et al. Veterans Administration cooperative study on antiplatelet agents in diabetic patients after amputation for gangrene, II: effects of aspirin and dipyridamole on atherosclerotic vascular disease rates . Diabetes Care. 1986;9:140-148.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Progression of Peripheral Occlusive Arterial Disease in Diabetes Mellitus: What Factors Are Predictive?

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400040067015
Publisher site
See Article on Publisher Site

Abstract

Abstract The clinical, biochemical, and vascular laboratory measurements potentially associated with the development and/or progression of peripheral occlusive arterial disease (POAD) were assessed during a 4-year period in 110 normal control subjects, 112 patients with POAD without diabetes mellitus, 240 patients with diabetes mellitus without POAD, and 100 patients with diabetes mellitus and POAD. Age, history of hypertension or coronary heart disease, history of cigarette smoking, presence of POAD, systolic blood pressure, and β-thromboglobulin level were associated with progression of POAD. A multivariate logistic regression model indicated that the presence of diabetes mellitus or POAD or both at baseline, decreased postexercise ankle-brachial index, increased arm systolic blood pressure, and current smoking were independently associated with progression of POAD. This study suggests that cessation of smoking and control of hypertension are essential treatment modifications to decrease the risk of progression of peripheral vascular disease in diabetic patients. (Arch Intern Med. 1991;151:717-721) References 1. Zimmerman BR, Palumbo PJ, O'Fallon WM, Osmundson PJ, Kazmier FJ. A prospective study of peripheral occlusive arterial disease in diabetes, I: clinical characteristics of the subjects . Mayo Clin Proc . 1981;56:217-222. 2. Osmundson PJ, Chesebro JH, O'Fallon WM, Zimmerman BR, Kazmier JF, Palumbo PJ. A prospective study of peripheral occlusive arterial disease in diabetes, II: vascular laboratory assessment . Mayo Clin Proc . 1981;56:223-232. 3. Zimmerman BR, Palumbo PJ, O'Fallon WM, Ellefson RD, Osmundson PJ, Kazmier FJ. A prospective study of peripheral occlusive arterial disease in diabetes, III: initial lipid and lipoprotein findings . Mayo Clin Proc . 1981;56:233-242. 4. Kazmier FJ, Bowie EJW, O'Fallon WM, Zimmerman BR, Osmundson PJ, Palumbo PJ. A prospective study of peripheral occlusive arterial disease in diabetes, IV: platelet and plasma functions . Mayo Clin Proc . 1981;56:243-253. 5. Osmundson PJ, O'Fallon WM, Zimmerman BR, Kazmier FJ, Langworthy AL, Palumbo PJ. Course of peripheral occlusive arterial disease in diabetes: vascular laboratory assessment . Diabetes Care . 1990;13:143-152.Crossref 6. Abraham EC, Huff TA, Cope ND, Wilson JB Jr, Bransome ED Jr, Huisman THJ. Determination of the glycosylated hemoglobins (Hb AI) with a new microcolumn procedure: suitability of the technique for assessing the clinical management of diabetes mellitus . Diabetes. 1978;27:931-937.Crossref 7. Beutler E. Red Cell Metabolism: A Manual of Biochemical Methods . New York, NY: Grune & Stratton; 1971. 8. Burrows AW, Chavin SI, Hockaday TDR. Plasma-thromboglobulin concentrations in diabetes mellitus . Lancet. 1978;1:235-237.Crossref 9. Fuster V, Kazmier FJ, Cash JD, Bowie EJW, Owen CA Jr. Assay of platelet factor 4 in plasma . Mayo Clin Proc. 1973;48:103-106. 10. Green MS. Evaluating the discriminatory power of a multiple logistic regression model . Stat Med. 1988;7:519-524.Crossref 11. Colwell JA, Bingham SF, Abraira C, et al. Veterans Administration cooperative study on antiplatelet agents in diabetic patients after amputation for gangrene, II: effects of aspirin and dipyridamole on atherosclerotic vascular disease rates . Diabetes Care. 1986;9:140-148.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 1, 1991

References