Document Detail

Impaired peripheral circulation in lower-leg arteries caused by higher arterial stiffness and greater vascular resistance associates with nephropathy in type 2 diabetic patients with normal ankle-brachial indices.
MedLine Citation:
PMID:  18336947     Owner:  NLM     Status:  MEDLINE    
Diabetic nephropathy is a major cause of lower-limb amputation. We enrolled 250 type 2 diabetic patients without apparent occlusive peripheral arterial disease (ankle-brachial indices >0.9) and 40 age-matched nondiabetic subjects consecutively admitted to our hospital. Flow volume and resistive index (RI), an index of vascular resistance, at the popliteal artery were evaluated using gated two-dimensional cine-mode phase-contrast magnetic resonance imaging. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial distensibility. Flow volume was negatively correlated with both baPWV (p=0.0009) and RI (p<0.0001) among the patients. When the patients were grouped into four subgroups with or without albuminuria and renal insufficiency according to the levels of urinary albumin excretion rate (>or=20 or <20microg/min) and estimated glomerular filtration rate (eGFR) (<60 or >or=60ml/min/1.73m(2)), albuminuric patients with renal insufficiency (n=30) showed the lowest flow volume (p=0.0078) and the highest baPWV (p=0.0006) and RI (p=0.0274) among the groups. Simple linear regression analyses demonstrated that eGFR correlated positively with flow volume (p=0.0020) and negatively with baPWV (p=0.0258) and RI (p=0.0029) in patients with albuminuria (n=92), but not with normoalbuminuria (n=158). Impaired peripheral circulation in lower-leg arteries associates with nephropathy in diabetic patients even though they have normal ankle-brachial indices.
Toru Yoshimura; Eiji Suzuki; Isamu Ito; Masayoshi Sakaguchi; Takashi Uzu; Yoshihiko Nishio; Hiroshi Maegawa; Shigehiro Morikawa; Toshiro Inubushi; Akitaka Hisatomi; Kazuma Fujimoto; Jun Takeda; Atsunori Kashiwagi
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Publication Detail:
Type:  Journal Article     Date:  2008-03-11
Journal Detail:
Title:  Diabetes research and clinical practice     Volume:  80     ISSN:  1872-8227     ISO Abbreviation:  Diabetes Res. Clin. Pract.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-13     Completed Date:  2008-08-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508335     Medline TA:  Diabetes Res Clin Pract     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  416-23     Citation Subset:  IM    
Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
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MeSH Terms
Arterial Occlusive Diseases / physiopathology*
Blood Flow Velocity*
Blood Pressure
Brachial Artery / physiopathology*
Diabetes Mellitus, Type 2 / physiopathology*
Diabetic Angiopathies / physiopathology*
Diabetic Nephropathies / physiopathology*
Hemoglobin A, Glycosylated / analysis
Middle Aged
Peripheral Vascular Diseases / physiopathology*
Vascular Resistance
Reg. No./Substance:
0/Hemoglobin A, Glycosylated

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