Amoako Joachim, Saa Matthan Fayia, Bannerman-Williams Emmanuel, Bruce Anastasia Naa Koshie, Ansong Maame Boatemaa, Danquah Alexander, Ablorh Abraham, Kwaw Wills Nii Adjetey, Adjei Michael, Awuttey Emmanuel K, Dakubo Isabella D, Vormatu Patience Akos, Ennin Isaac Ekow, Hayfron-Benjamin Charles Frederick
Department of Surgery, University of Ghana Medical School, Ghana.
Department of Physiology, University of Ghana Medical School, Ghana.
Int J Cardiol Cardiovasc Risk Prev. 2025 Jul 11;26:200469. doi: 10.1016/j.ijcrp.2025.200469. eCollection 2025 Sep.
Globally, peripheral artery disease (PAD) affects >200 million people, disproportionately affecting people with diabetes. Prior studies characterizing the risk profile of PAD in diabetes have excluded West Africans, whose vascular biology is relevantly different. This study characterized the aggregate effect of modifiable risk factors on PAD in West Africans with diabetes.
This was a cross-sectional study among 803 Ghanaian adults with diabetes. PAD was defined as ankle-brachial pressure index ≤0.90 and/or intermittent claudication. A multivariate logistic regression model was built to identify modifiable PAD risk factors, which were used to define the number of risk factors for each participant. The odds of PAD were determined based on the number of modifiable risk factors.
The mean age, diabetes duration, and HbAc concentrations were 59.81(±9.95) years, 13.66(±7.89) years, and 8.45(±1.94) %, respectively. PAD prevalence was 25.8 %. In a multivariable regression model, hypertension [odds ratio 2.00, 95 % confidence interval 1.33-3.01], chronic kidney disease [1.54(1.11-2.14)], central obesity [1.58(1.05-2.39)], and elevated LDL-cholesterol concentration [1.42(1.02-1.97)] were independently associated with PAD. After adjustment for age, sex, and diabetes duration, the odds of PAD increased with each additional risk factor from a 2.02-fold increase [OR 2.02, 95 %CI 0.69-5.97) in the presence of two risk factors, to 3.51-fold [3.51(1.20-10.24)] for three risk factors, and nearly five-fold [4.80 (1.57-14.67)] for four risk factors.
West Africans with diabetes are very sensitive to the cumulative effect of hypertension, chronic kidney disease, central obesity, and elevated LDL cholesterol concentration for PAD. These findings provide data to guide PAD screening/treatment strategies.
在全球范围内，外周动脉疾病（PAD）影响着超过2亿人，糖尿病患者受其影响的比例尤其高。此前关于糖尿病患者PAD风险特征的研究排除了血管生物学存在显著差异的西非人群。本研究旨在确定可改变的风险因素对患有糖尿病的西非人群PAD的综合影响。
这是一项针对803名加纳成年糖尿病患者的横断面研究。PAD被定义为踝臂指数≤0.90和/或间歇性跛行。构建多变量逻辑回归模型以识别可改变的PAD风险因素，并据此确定每位参与者的风险因素数量。根据可改变的风险因素数量确定患PAD的几率。
平均年龄、糖尿病病程和糖化血红蛋白（HbAc）浓度分别为59.81（±9.95）岁、13.66（±7.89）年和8.45（±1.94）%。PAD患病率为25.8%。在多变量回归模型中，高血压[比值比2.00，95%置信区间1.33 - 3.01]、慢性肾病[1.54（1.11 - 2.14）]、中心性肥胖[1.58（1.05 - 2.39）]和低密度脂蛋白胆固醇浓度升高[1.42（1.02 - 1.97）]与PAD独立相关。在调整年龄、性别和糖尿病病程后，每增加一个风险因素，患PAD的几率就会增加，从存在两个风险因素时增加2.02倍[比值比2.02，95%置信区间0.69 - 5.97）]，到三个风险因素时增加3.51倍[3.51（1.20 - 10.24）]，四个风险因素时增加近五倍[4.80（1.57 - 14.67）]。
患有糖尿病的西非人群对高血压、慢性肾病、中心性肥胖和低密度脂蛋白胆固醇浓度升高对PAD的累积影响非常敏感。这些发现为指导PAD筛查/治疗策略提供了数据。
