Lower-extremity arterial disease risk high among women with type 2 diabetes, metabolic syndrome
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Women with type 2 diabetes are more likely to develop lower-extremity arterial disease if they also have metabolic syndrome, according to findings published in the Journal of Diabetes and its Complications.
“Metabolic syndrome is associated with an increased risk of lower-extremity arterial disease in female type 2 diabetes patients. In contrast, there was no association between metabolic syndrome and lower-extremity arterial disease in males,” Linong Ji, MD, a professor in the department of endocrinology at Peking University People’s Hospital in Beijing, and colleagues wrote. “Previous research has shown that patients with metabolic syndrome have elevated levels of hemostatic and inflammatory biomarkers. It is possible that inflammatory markers within atherosclerotic plaque may mediate the association of metabolic syndrome with lower-extremity arterial disease.”
Ji and colleagues assessed systolic blood pressure at the upper ankle and upper arm among 8,374 adults aged 40 years or older with type 2 diabetes (46% women) to determine ankle-brachial index, which was used to diagnose lower-extremity arterial disease. Participants with an ankle-brachial index of 0.9 or lower were considered to have lower-extremity arterial disease. The researchers also assessed hyperglycemia, hypertension, hypertriglyceridemia and obesity status to identify metabolic syndrome, which was confirmed if a participant had at least three of the conditions.
Lower-extremity arterial disease occurred in 1,809 participants (mean age, 67.64 years), and 826 of these participants had metabolic syndrome — 55.65% of women and 47.52% of men had both conditions.
Women with type 2 diabetes and metabolic syndrome were more likely to develop lower-extremity arterial disease than those who did not have metabolic syndrome in fully adjusted models (OR = 1.33; 95% CI, 1.12-1.58). This powered an overall association between metabolic syndrome and lower-extremity arterial disease (OR = 1.22; 95% CI, 1.09-1.37), according to the researchers, although men with metabolic syndrome were not more likely to have lower-extremity arterial disease than those without the syndrome.
“Although the detailed mechanisms behind the associations of metabolic syndrome with lower-extremity arterial disease in females remain not fully resolved, several potential pathogenesis mechanisms have been suggested,” the researchers wrote. “Estrogen and other sex hormones have vein protective properties that reduce the prevalence of atherosclerosis in women of a younger age, yet estrogen is a risk factor for the development of vascular disease in women of an older age. Furthermore, several reports have shown that women presenting with lower-extremity arterial disease tend to be older.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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