What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Peripheral vascular disease (n=3696778). Intervention: Diabetes mellitus vs. Without diabetes. Primary outcome: Lower extremity peripheral artery disease (PAD) (OR 1.42, 95% CI 1.41-1.4, p=<0.0001).

What does this research mean for the field?

Diabetes is associated with increased odds of peripheral artery disease and carotid artery stenosis, but decreased odds of abdominal aortic aneurysm. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate the association between diabetes mellitus and distinct clinical phenotypes of peripheral vascular disease across different arterial beds.

April 5, 2014Diabetes CareOpen Access

Diabetes and Vascular Disease in Different Arterial Territories

Q: What are the key findings of this study?

Diabetes was associated with increased odds of peripheral artery disease (OR 1.42) and carotid artery stenosis (OR 1.45), but decreased odds of abdominal aortic aneurysm (OR 0.86).

Q: What does this research mean for the field?

Diabetes is associated with increased odds of peripheral artery disease and carotid artery stenosis, but decreased odds of abdominal aortic aneurysm. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To investigate the association between diabetes mellitus and distinct clinical phenotypes of peripheral vascular disease across different arterial beds.

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Key result

Diabetes linked to ~42% higher PAD risk, increased CAS risk, but lower AAA risk.

OR 1.42
95% CI 1.41-1.4
P<0.0001
n=3,696,778

Why the study?

Does diabetes mellitus alter the odds of different phenotypes of peripheral vascular disease in a screening population?

Population

3,696,778 participants of the Life Line Screening survey between 2003 and 2008

Comparison

Diabetes mellitus vs No diabetes mellitus

Design

Cross-sectional

Authors

BSBinita ShahInterventional Cardiology CRCaron RockmanHackensack University Medical Center YGYu GuoBrigham and Women's Hospital

Discussion

Member takes

Implication

Supports differential vascular risks in diabetes screening; hypothesis-generating for phenotype-specific prevention trials.

Key Points

To investigate the association between diabetes mellitus and distinct clinical phenotypes of peripheral vascular disease across different arterial beds.
Cross-sectional analysis of 3,696,778 participants evaluated in the Life Line Screening survey between 2003 and 2008.
Vascular disease phenotypes were assessed via ultrasound and pressure measurements: lower extremity peripheral artery disease (ankle-brachial pressure index <0.90 or prior revascularization), carotid artery stenosis (≥50% stenosis or prior revascularization), and abdominal aortic aneurysm (infrarenal aortic diameter ≥3 cm or prior repair).
Multivariable logistic regression was used to evaluate odds ratios and 95% confidence intervals adjusting for baseline demographics and cardiovascular risk factors.
Diabetes was present in 10.8% of the cohort (n = 399,884), with crude prevalence of all three vascular phenotypes significantly elevated in participants with diabetes compared to those without (P < 0.0001).
Multivariable adjustment revealed significant divergence by vascular bed: diabetes was associated with increased odds of peripheral artery disease (OR 1.42, 95% CI 1.41–1.44, P < 0.0001) and carotid artery stenosis (OR 1.45, 95% CI 1.43–1.47, P < 0.0001).
In contrast, diabetes was inversely associated with abdominal aortic aneurysm (OR 0.86, 95% CI 0.84–0.88, P < 0.0001), with these territory-specific patterns persisting across both asymptomatic and increasingly severe disease.

Study Design

Type

Cross-Sectional (n=3,696,778)

Structured PICO

Does diabetes mellitus alter the odds of different phenotypes of peripheral vascular disease in a screening population?

Population

3,696,778 participants of the Life Line Screening survey evaluated for the relationship between diabetes and peripheral vascular disease phenotypes.

Exposure

Diabetes mellitus

Comparator

No diabetes mellitus

Outcome

Prevalence of lower extremity peripheral artery disease (PAD), carotid artery stenosis (CAS), and abdominal aortic aneurysm (AAA)

Main Result

Odds Ratio: 1.42 (95% CI 1.41–1.4)

p-value: p=<0.0001

Diabetes is associated with an increased risk of peripheral artery disease and carotid artery stenosis, but a decreased risk of abdominal aortic aneurysm.

Cite This Study

Shah et al. (2014) conducted a cross-sectional in Peripheral vascular disease (n=3,696,778). Diabetes mellitus vs. Without diabetes was evaluated on Lower extremity peripheral artery disease (PAD) (OR 1.42, 95% CI 1.41-1.4, p=<0.0001). Diabetes was associated with increased odds of peripheral artery disease (OR 1.42) and carotid artery stenosis (OR 1.45), but decreased odds of abdominal aortic aneurysm (OR 0.86).

synapsesocial.com/papers/6aa510c55b13064ba7dc4ce1 https://doi.org/10.2337/dc13-2432

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Diabetes and Vascular Disease in Different Arterial Territories

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Diabetes and Vascular Disease in Different Arterial Territories

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider