Abu-Jableh Waqas, Younis Ahmad, Hjazeen Anees, Mashaqbeh Eman, Al-Sharif Ehab
Advanced Diabetic Foot Nurse Specialization, Royal Medical Services, Amman, JOR.
Community Health Nursing and Biostatistics, Royal Medical Services, Amman, JOR.
Cureus. 2024 Nov 15;16(11):e73722. doi: 10.7759/cureus.73722. eCollection 2024 Nov.
Background and objective Peripheral arterial disease (PAD) is a common disorder that is usually associated with leg symptoms such as intermittent claudication (IC), which could be masked by peripheral neuropathy in diabetic patients. In this study, we aimed to assess the prevalence and associated risk factors of asymptomatic PAD among Jordanian patients with diabetic foot ulcers. Methods A cross-sectional study involving diabetic foot patients attending the diabetic foot clinic at the Medical City in Royal Medical Services in Amman, Jordan, was conducted from January 2023 to March 2024. The criteria for the diagnosis of asymptomatic PAD were as follows: patients with toe brachial index (TBI) <0.7 and no leg symptoms as determined by the San Diego Claudication Questionnaire (SDCQ). Results PAD was observed in 38 out of 133 patients (28.6%). Of these, 26 patients (68.4%) had asymptomatic PAD. Statistically significant associations were observed between PAD and male gender, former smoking, cerebrovascular disease (CVD), age, duration of diabetes, and high-density lipoprotein (HDL). Multiple binary logistic regression showed that ex-smoking and age had a significant impact on developing PAD; ex-smoker patients were 4.75 times [95% confidence interval (CI): 1.26-17.90, p=0.021] more likely to have PAD than non-smokers, and the odds ratio (OR) of having PAD increased by 1.05 times for each additional year of patient age (95% CI: 1.004-1.095, p=0.032). In investigating factors associated with asymptomatic PAD, only hypertension showed significant results. Conclusions The prevalence of asymptomatic PAD is relatively high in diabetic foot patients. PAD may delay wound healing and lead to limp loss and poorer quality of life.
背景与目的 外周动脉疾病（PAD）是一种常见疾病，通常与腿部症状如间歇性跛行（IC）相关，而在糖尿病患者中，这些症状可能会被周围神经病变所掩盖。在本研究中，我们旨在评估约旦糖尿病足溃疡患者中无症状PAD的患病率及相关危险因素。方法 于2023年1月至2024年3月在约旦安曼皇家医疗服务机构医疗城的糖尿病足诊所进行了一项横断面研究，纳入就诊的糖尿病足患者。无症状PAD的诊断标准如下：趾臂指数（TBI）<0.7且根据圣地亚哥跛行问卷（SDCQ）判定无腿部症状的患者。结果 133例患者中有38例（28.6%）观察到PAD。其中，26例患者（68.4%）为无症状PAD。观察到PAD与男性、既往吸烟、脑血管疾病（CVD）、年龄、糖尿病病程和高密度脂蛋白（HDL）之间存在统计学显著关联。多元二元逻辑回归显示，既往吸烟和年龄对发生PAD有显著影响；既往吸烟者患PAD的可能性是非吸烟者的4.75倍[95%置信区间（CI）：1.26 - 17.90，p = 0.021]，患者年龄每增加一岁，患PAD的比值比（OR）增加1.05倍（95% CI：1.004 - 1.095，p = 0.032）。在调查与无症状PAD相关的因素时，仅高血压显示出显著结果。结论 糖尿病足患者中无症状PAD的患病率相对较高。PAD可能会延迟伤口愈合，导致肢体丧失和生活质量下降。
