Fibrinogen and Albuminuria are Related to the Presence and Severity of Peripheral Arterial Disease in Women with Type 2 Diabetes Mellitus

Abstract

The relationship between the ultrasonographically determined presence and severity of peripheral arterial disease (PAD) and cardiovascular risk factors was studied in 30 post menopausal, nonsmoking women with type 2 diabetes mellitus. PAD was established on the basis of decreased ankle/arm index (AAI) of < 0.9 in 15 patients. The control group included 15 type 2 diabetic women with AAI > 1.0. There were no differences with respect to diabetes control and systolic blood pressure between the patients with PAD and controls. The patients with PAD had significantly higher mean fibrinogen concentrations (4.75 ±0.35 vs 3.53 ±0.36 g/L, P<0.01) and urinary albumin excretion (UAE) values (893 ±501 vs 57 ±24 mg/day, P<0.05) than the subjects in the control group. There was no significant difference between the study groups with respect to any lipid variables. Significant partial correlations adjusted for age were observed between AAI (which expressed the severity of PAD) and log UAE (r=-0.55, P<0.01), creatinine ( r=-0.48, P<0.01) and fibrinogen ( r=-0.45, P<0.01). In the multiple stepwise regression analysis with AAI as a dependent variable, only fibrinogen (P=0.033) and log UAE (P=0.029) were included into the best model. In conclusion, in nonsmoking women with type 2 diabetes mellitus, fibrinogen and albuminuria were the only risk factors associated with both the presence and severity of peripheral arterial disease.