Analysis of diagnostic methods for peripheral arterial disease in patients with Diabetes mellitus

Authors

DOI:

https://doi.org/10.33448/rsd-v12i4.41293

Keywords:

Peripheral Arterial Disease; Cardiovascular Diseases; Diabetes Mellitus; Diagnostic Techniques and Procedures.

Abstract

Objective: To synthesize information about the main methods for diagnosing obstructive arterial disease in patients with diabetes mellitus. Methodology: Integrative literature review aiming to answer the guiding question originated from the PICo strategy "How is the diagnosis of PAD in diabetic patients made?" based on articles selected from the MEDLINE/PubMed®, LILACS and WoS platforms. Results: For the diagnosis of obstructive arterial disease in diabetics, the main clinical method is the Ankle Brachial Index, which is a very advantageous technique for its sensitivity, easy execution and low cost. Also, among the laboratory methods, osteoprotegerin has high plasma levels in these patients; high brain natriuretic peptide is indicated as a predictor; and there is also omentin, which is useful for follow-up and severity assessment. Furthermore, as an imaging exam, angiography is the gold standard for this recognition, but it is an expensive and invasive method; on the other hand, Doppler ultrasound is a practical and effective tool to predict this form of vascular complication. Conclusion: It was possible to synthesize the main clinical and laboratory findings that can be examined during the care of patients with diabetes and that may be useful to detect PAD in these individuals. However, it is suggested that further studies be conducted to explore the new methods and their efficacy to enable early and efficient diagnosis.

References

AbuRahma, A. F., Adams, E., AbuRahma, J., Mata, L. A., Dean, L. S., Caron, C., & Sloan, J. (2020). Critical analysis and limitations of resting ankle-brachial index in the diagnosis of symptomatic peripheral arterial disease patients and the role of diabetes mellitus and chronic kidney disease. Journal of Vascular Surgery, 71(3), 937–945.

Aguilera Lagos, R., Díaz López, E. J., Colman Juárez, B. L., Carranza Pagoada, R. E., Padilla Meza, J. C., & Cáceres Munguía, G. I. (2020). Enfermedad arterial periférica y diabetes mellitus de tipo 2 en atención primaria. Rev. cuba. angiol. cir. vasc, 21(2), e113–e113.

Akram, J., Aamir, A., Basit, A., Qureshi, M. S., Mehmood, T., Shahid, S. K., Khoso, I. A., Ebrahim, M. A., & Omair, A. (2011). Prevalence of peripheral arterial disease in type 2 diabetics in Pakistan. JPMA. The Journal of the Pakistan Medical Association, 61(7), 644–648.

Althouse, A. D., Abbott, J. D., Forker, A. D., Bertolet, M., Barinas-Mitchell, E., Thurston, R. C., Mulukutla, S., Aboyans, V., & Brooks, M. M. (2014). Risk factors for incident peripheral arterial disease in type 2 diabetes: Results from the Bypass Angioplasty Revascularization Investigation in type 2 Diabetes (BARI 2D) Trial. Diabetes Care, 37(5), 1346–1352.

Arora, E., Maiya, A. G., Devasia, T., Bhat, R., & Kamath, G. (2019). Prevalence of peripheral arterial disease among type 2 diabetes mellitus in coastal Karnataka. Diabetes & Metabolic Syndrome-Clinical Research & Reviews, 13(2), 1251–1253.

Babar, G., Clements, M., Dai, H., & Raghuveer, G. (2019). Assessment of biomarkers of inflammation and premature atherosclerosis in adolescents with type-1 diabetes mellitus. Journal Of Pediatric Endocrinology & Metabolism, 32(2), 109–113.

Bąk, E., Marcisz, C., Kadłubowska, M., Michalik, A., Krawczyk, B., Dobrzyń-Matusiak, D., Krzemińska, S., Fiałkowski, T., Glądys, E., & Drosdzol-Cop, A. (2016). Independent Factors of Changes of Ankle-Brachial Index in Peripheral Arterial Occlusive Disease in Elderly Patients with or without Diabetes. International Journal of Environmental Research and Public Health, 13(11).

Barshes, N. R., Flores, E., Belkin, M., Kougias, P., Armstrong, D. G., & Mills, J. L. S. (2016). The accuracy and cost-effectiveness of strategies used to identify peripheral artery disease among patients with diabetic foot ulcers. Journal of Vascular Surgery, 64(6), 1682-1690.e3.

Bessueille, L., & Magne, D. (2015). Inflammation: a culprit for vascular calcification in atherosclerosis and diabetes. Cellular and Molecular Life Sciences, 72(13), 2475–2489.

Bimbato, L. D. M., Pereira, F. L. A., Paladini Filho, P. H., Creimer, H. P., Silva, V. M., Tieppo, A., & Morelato, R. L. (2018). Doença arterial obstrutiva assintomática e Índice Tornozelo-Braquial em pacientes com diabetes mellitus tipo 2. Rev. Soc. Bras. Clín. Méd, 16(1), 18–20. LILACS.

Biscetti, F., Nardella, E., Bonadia, N., Angelini, F., Pitocco, D., Santoliquido, A., Filipponi, M., Landolfi, R., & Flex, A. (2019). Association between plasma omentin-1 levels in type 2 diabetic patients and peripheral artery disease. Cardiovascular Diabetology, 18(1), 74.

Buschmann, E. E., Li, L., Brix, M., Zietzer, A., Hillmeister, P., Busjahn, A., Bramlage, P., & Buschmann, I. (2018). A novel computer-aided diagnostic approach for detecting peripheral arterial disease in patients with diabetes. PloS One, 13(6), e0199374.

Calle, M. C., & Fernandez, M. L. (2012). Inflammation and type 2 diabetes. Diabetes & metabolism, 38(3), 183–191.

Chevtchouk, L., Silva, M. H. S. da, & Nascimento, O. J. M. do. (2017). Ankle-brachial index and diabetic neuropathy: Study of 225 patients. Arquivos de Neuro-Psiquiatria, 75(8), 533–538.

Devrajani, B. R., Shaikh, S., Lashari, N. A., Shah, S. Z. A., & Ali, S. (2017). Ankle Brachial Index (Abi) In Patients With Type 2 Diabetes Mellitus. Indo American Journal Of Pharmaceutical Sciences, 4(11), 4353–4357.

Esteghamati, A., Aflatoonian, M., Rad, M. V., Mazaheri, T., Mousavizadeh, M., Nakhjavani, M., & Noshad, S. (2015). Association of osteoprotegerin with peripheral artery disease in patients with type 2 diabetes. Archives of Cardiovascular Diseases, 108(8–9), 412–419.

Felício, J. S., Koury, C. C., Abdallah Zahalan, N., de Souza Resende, F., Nascimento de Lemos, M., Jardim da Motta Corrêa Pinto, R., Jorge Kzan de Souza Neto, N., Imbelloni Farias de Franco, I., Neres Iunes de Oliveira, M. C., Leite de Alcântara, A., Contente Braga de Souza, A. C., Santos, M. C. D., Neves Marques de Queiroz, N., Marques da Costa Farias, L., Silva, D. D. da, Miléo Felício, K., Trindade Cunha de Melo, F., & Abrahão Neto, J. F. (2019). Ankle-brachial index and peripheral arterial disease: An evaluation including a type 2 diabetes mellitus drug-naïve patients cohort. Diabetes & Vascular Disease Research, 16(4), 344–350.

Feng, B., Xu, G., Sun, K., Duan, K., Shi, B., & Zhang, N. (2020). Association of serum Cyr61 levels with peripheral arterial disease in subjects with type 2 diabetes. Cardiovascular Diabetology, 19(1), 194.

Galvão, Taís Freire, & Pereira, Mauricio Gomes. (2014). Revisões sistemáticas da literatura: passos para sua elaboração. Epidemiologia e Serviços de Saúde, 23(1), 183-184.

Gazzaruso, C., Coppola, A., Falcone, C., Luppi, C., Montalcini, T., Baffero, E., Gallotti, P., Pujia, A., Solerte, S. B., Pelissero, G., & Giustina, A. (2013). Transcutaneous oxygen tension as a potential predictor of cardiovascular events in type 2 diabetes: Comparison with ankle-brachial index. Diabetes Care, 36(6), 1720–1725.

Homza, M., Machaczka, O., Porzer, M., Kozak, M., Plasek, J., & Sipula, D. (2019). Comparison of different methods of ABI acquisition for detection of peripheral artery disease in diabetic patients. Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia, 163(3), 227–232.

Hur, K. Y., Jun, J. E., Choi, Y. J., Lee, Y. H., Kim, D. J., Park, S. W., Huh, B. W., Lee, E. J., Jee, S. H., Huh, K. B., & Choi, S. H. (2018). Color Doppler Ultrasonography Is a Useful Tool for Diagnosis of Peripheral Artery Disease in Type 2 Diabetes Mellitus Patients with Ankle-Brachial Index 0.91 to 1.40. Diabetes & Metabolism Journal, 42(1), 63–73.

Jin, Q.-H., Ye, W.-L., Chen, H.-H., He, X.-J., Li, T.-L., Liu, Q., Zhong, L., Xu, L., & Han, C.-M. (2014). Levels of brain natriuretic peptide are associated with peripheral arterial disease in subjects with type-2 diabetes mellitus. BMC Endocrine Disorders, 14, 27.

Li, W., Fan, D., Hong, M., Hong-xiang, W., & Shi, Z. (2011). Prevalence and related risk factors of peripheral arterial disease in elderly patients with type 2 diabetes in Wuhan, Central China. CHINESE MEDICAL JOURNAL, 124(24), 4264–4268.

Li, Y., Li, Q., Liang, S., Liang, X., Zhou, W., He, H., Jin, R., Wang, K., Zhu, Z., & Yan, Z. (2017). A novel use of hill function and utility of 99mTc-MIBI scintigraphy to detect earlier lower extremity microvascular perfusion in patients with type 2 diabetes. Medicine, 96(38), e8038.

Liu, X., Zhang, N., Fan, Z., Feng, F., Yang, Q., Zheng, H., Liu, P., & Li, D. (2014). Detection of infragenual arterial disease using non-contrast-enhanced MR angiography in patients with diabetes. Journal of Magnetic Resonance Imaging: JMRI, 40(6), 1422–1429.

Luccia, N. (2003). Reabilitação pós-amputação. Em: G. B. B. Pitta, A. A. Castro & E. Burihan (Orgs.), Angiologia e cirurgia vascular: guia ilustrado. Maceió: UNCISAL/ECMAL & LAVA. <http://www.lava.med.br/livro>

Miyashima, M., Shoji, T., Kakutani, Y., Yamazaki, Y., Ochi, A., Morioka, T., Shinohara-Mitsuki, K., Fukumoto, S., Shioi, A., Inaba, M., & Emoto, M. (2020). Inter-Arm Blood Pressure Difference in Diabetes Mellitus and Its Preferential Association with Peripheral Artery Disease. Journal of Atherosclerosis and Thrombosis, 27(8), 780–788.

Muzy, J., Campos, M. R., Emmerick, I., Silva, R. S. da, & Schramm, J. M. de A. (2021). Prevalência de diabetes mellitus e suas complicações e caracterização das lacunas na atenção à saúde a partir da triangulação de pesquisas. Cadernos de Saúde Pública, 37(5).

Mwebaze, R. M., & Kibirige, D. (2014). Peripheral Arterial Disease among Adult Diabetic Patients Attending a Large Outpatient Diabetic Clinic at a National Referral Hospital in Uganda: A Descriptive Cross Sectional Study. PLOS ONE, 9(8).

Neto, S. S., & do Nascimento, J. L. M. (2007). Doença arterial obstrutiva periférica: novas perspectivas de fatores de risco. Revista Paraense de Medicina, 21(2), 35-39.

Niu, Y., Zhang, W., Yang, Z., Li, X., Wen, J., Wang, S., Zhang, H., Wang, X., Zhou, H., Fang, W., Qin, L., & Su, Q. (2015). Association of plasma osteoprotegerin levels with the severity of lower extremity arterial disease in patients with type 2 diabetes. BMC Cardiovascular Disorders, 15, 86.

Normahani, P., Agrawal, R., Bravis, V., Falinska, A., Bloomfield, L., Mehar, Z., Gaulton, D., Sangster, A., Arkle, T., Gomm, C., Aslam, M., Standfield, N. J., & Jaffer, U. (2018). Effectiveness of a multicenter training programme to teach point-of-care vascular ultrasound for the detection of peripheral arterial disease in people with diabetes. Journal of Foot and Ankle Research, 11, 41.

Normahani, P., Mustafa, C., Standfield, N. J., Duguid, C., Fox, M., & Jaffer, U. (2018). Management of peripheral arterial disease in diabetes: A national survey of podiatry practice in the United Kingdom. Journal of Foot and Ankle Research, 11, 29.

Normahani, P., Poushpas, S., Alaa, M., Bravis, V., Aslam, M., & Jaffer, U. (2020). Study protocol for a comparative diagnostic accuracy study of bedside tests used to detect arterial disease in diabetes: TEsting for Arterial disease in Diabetes (TrEAD) study. BMJ Open, 10(2), e033753.

Okello, S., Millard, A., Owori, R., Asiimwe, S. B., Siedner, M. J., Rwebembera, J., Wilson, L. A., Moore, C. C., & Annex, B. H. (2014). Prevalence of lower extremity peripheral artery disease among adult diabetes patients in southwestern Uganda. BMC Cardiovascular Disorders, 14, 75.

Poulsen, M. K., Nybo, M., Dahl, J., Hosbond, S., Poulsen, T. S., Johansen, A., Høilund-Carlsen, P. F., Beck-Nielsen, H., Rasmussen, L. M., & Henriksen, J. E. (2011). Plasma osteoprotegerin is related to carotid and peripheral arterial disease, but not to myocardial ischemia in type 2 diabetes mellitus. Cardiovascular Diabetology, 10, 76.

Sales, A. T. do N. (2012). Prevalência de doença arterial obstrutiva periférica (DAOP) e alterações sensoriais em pacientes diabéticos tipo 2: impacto da DAOP sobre a qualidade de vida, nível de atividade física e composição corporal. Repositorio.ufrn.br.

Shaheen, R., & Sohail, S. (2010). A Doppler-Based Evaluation of Peripheral Lower Limb Arterial Insufficiency in Diabetes Mellitus. Jcpsp-Journal Of The College Of Physicians And Surgeons Pakistan, 20(1), 22–25.

Silva, J. C. C. B., & Burihan, E. (1999). Diagnóstico clínico da isquemia crítica dos membros. Rev Bras Clin Ter, 25(2), 71-9.

Slovacek, L., Slovackova, B., & Chovanec, V. (2007). The effect of femoral and popliteal percutaneous transluminal balloon angioplasty on patients’ quality of life. Sao Paulo Medical Journal, 125(4), 250–252.

Souza, M. T. D., Silva, M. D. D., & Carvalho, R. D. (2010). Integrative review: what is it? How to do it?. Einstein (São Paulo), 8(1), 102-106.

Tavares, Ermelindo & Monteiro, R & Rosário, V & Martins, C. (2010). Manifestações Cutâneas da Diabetes Mellitus. Revista Portuguesa de Diabetes. 5. 113-119.

Tehan, P. E., Barwick, A. L., Sebastian, M., & Chuter, V. H. (2017). Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: A cross-sectional retrospective case-control study. Journal of Foot and Ankle Research, 10, 58.

Tehan, P. E., Sebastian, M., Barwick, A. L., & Chuter, V. H. (2018). How sensitive and specific is continuous-wave Doppler for detecting peripheral arterial disease in people with and without diabetes? A cross-sectional study. Diabetes & Vascular Disease Research, 15(5), 396–401.

Torquato, M. T. da C. G., Montenegro Junior, R. M., Viana, L. A. L., Souza, R. A. H. G. de, Lanna, C. M. M., Lucas, J. C. B., Bidurin, C., & Foss, M. C. (2003). Prevalence of diabetes mellitus and impaired glucose tolerance in the urban population aged 30-69 years in Ribeirão Preto (São Paulo), Brazil. Sao Paulo Medical Journal, 121(6), 224–230.

Valdés Ramos, E., & Bencosme Rodríguez, N. (2010). Las complicaciones macrovasculares y su relación con algunas variables clínicas y bioquímicas en diabéticos tipo 2. Rev. cuba. endocrinol, 21(3), 256–268. LILACS.

Vera Pinaya, L. A., Jaimes Cadena, M. O., Burgos Portillo, I., & Burgos Portillo, R. B. (2014). Prevalencia de la enfermedad arterial periférica en pacientes diabeticos tipo 2, aplicando el indice tobillo - brazo en el hospital “seguro social universitario. Rev. méd. (La Paz), 20(1), 12–17. LILACS.

Weerarathna, T. P., Herath, M., Liyanage, G., Weerarathna, M. K., & Senadheera, V. (2019). Prevalence and Associations of Subclinical Peripheral Artery Disease among Patients with Type 2 Diabetes without Clinical Macrovascular Disease. International Journal of Preventive Medicine, 10, 106.

Yang, S. L., Zhu, L. Y., Han, R., Sun, L. L., Li, J. X., & Dou, J. T. (2017). Pathophysiology of peripheral arterial disease in diabetes mellitus. Journal of diabetes, 9(2), 133–140.

Yu, J. H., Hwang, J. Y., Shin, M.-S., Jung, C. H., Kim, E. H., Lee, S. A., Koh, E. H., Lee, W. J., Kim, M.-S., Park, J.-Y., & Lee, K.-U. (2011). The prevalence of peripheral arterial disease in korean patients with type 2 diabetes mellitus attending a university hospital. Diabetes & Metabolism Journal, 35(5), 543–550.

Yuan, J., Jia, P., Hua, L., Xin, Z., & Yang, J.-K. (2019). Vitamin D deficiency is associated with risk of developing peripheral arterial disease in type 2 diabetic patients. BMC Cardiovascular Disorders, 19(1), 145.

Zierfuss, B., Höbaus, C., Herz, C. T., Pesau, G., Koppensteiner, R., & Schernthaner, G.-H. (2020). Thrombospondin-4 increases with the severity of peripheral arterial disease and is associated with diabetes. Heart and Vessels, 35(1), 52–58.

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17/04/2023

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SANTANA, B. V. R. C. .; MENDES, I. P. G. .; REGO NETO, F. N. do .; SILVA, G. L. V. M. da C. e .; SOUSA , J. H. G. de .; ANDRADE, I. C. de O. .; MAGALHÃES NETO, E. de C. . Analysis of diagnostic methods for peripheral arterial disease in patients with Diabetes mellitus. Research, Society and Development, [S. l.], v. 12, n. 4, p. e25212441293, 2023. DOI: 10.33448/rsd-v12i4.41293. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/41293. Acesso em: 24 apr. 2024.

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Vol. 12 No. 4

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Review Article

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Copyright (c) 2023 Breno Vítor Rodrigues Coqueiro Santana; Isabella Pires Gomes Mendes; Francisco Nogueira do Rego Neto; Gabriel Lima Verde Moura da Costa e Silva; Jocsam Henrique Gomes de Sousa ; Ian Carlos de Oliveira Andrade; Elias de Carvalho Magalhães Neto

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