Peripheral arterial disease and oxidative stress in patients of the program for the prevention of complications of diabetes mellitus and dyslipidemias

Abstract

Introduction. Peripheral artery disease (PAD) is mainly caused by aterosclerosis and contributes to hyperglycemia and dyslipidemia that trigger oxidative stress and vascular damage.

Objectives. To determine the prevalence of PAD in patients with type-2 diabetes mellitus (DM2) and/or dyslipidemia, as well as some risk factor; also, to establish if urinary levels of 8-isoprostane-f2a (an oxidative stress marker) are elevated in patients with PAD.

Design. Cross-sectional, non-probabilistic, convenience study.

Materials and Methods. The sample consisted of 146 patients with DM2 and/or prediabetes and/or dyslipidemias.

Risk factors, symptoms related to PAD, ankle-brachial index measures, and biochemical variables (% HbA1c, fasting glycemia, lipid profile, creatinine, and albuminuria) were all recorded. 8-isoprostane-f2a levels in urine were determined with ELISA. The results of 8-iso-PGF2a/creatinuria concentrations were analyzed using the R statistics package. The comparison of risk factors was performed using the ANOVA/Kruskal-Wallis test. ROC curves were generated to analyze the biomarker's discriminant power. The combined analysis of laboratory results and risk factors was performed using multivariate logistic regression.

Results. A prevalence of PAD was seen in 10 diabetic patients. The following risk factors were found: smoking, dyslipidemia, poor metabolic control, overweight or obesity. There was no evidence of an increase in urinary 8-isoprostane-f2a in these subjects.

Conclusions. The prevalence of PAD was less than in other studies, probably due to regular medical follow-up. In this study, the determination of urinary 8-isoprostane-f2a by ELISA did not allow for the identification of early phases of PAD; the study of other oxidative stress markers is recommended