[Peripheral arterial disease in black African diabetics: epidemioclinical, ultrasonographic profile and determining factors].

Autor: Mahamat-Azaki O; Service de cardiologie, CHU de la Référence Nationale. BP : 130 Ndjamena-Tchad.. Electronic address: omrzaki11@gmail.com., Zakaria AZ; Service de cardiologie, CHU de la Référence Nationale. BP : 130 Ndjamena-Tchad., Oumar A; Service de diabétologie, CHU de la Référence Nationale. BP : 130 Ndjamena-Tchad., Mahamat YK; Service de médecine, Hôpital Provincial de Farcha. BP : 3054, Ndjamena-Tchad., Ali AA; Service de médecine, CHU de la Renaissance. BP : 2029 Ndjamena-Tchad., Lackdjoulki D; Service de cardiologie, CHU de la Référence Nationale. BP : 130 Ndjamena-Tchad., Soya E; Service des explorations externes de l'Institut de Cardiologie d'Abidjan, BPV 206 Abidjan, Côte d'Ivoire.
Jazyk: francouzština
Zdroj: Annales de cardiologie et d'angeiologie [Ann Cardiol Angeiol (Paris)] 2024 Jun; Vol. 73 (3), pp. 101736. Date of Electronic Publication: 2024 Apr 17.
DOI: 10.1016/j.ancard.2024.101736
Abstrakt: Background: Diabetes can lead to micro and macro-angiopathies. The peripheral arterial disease (PAD) is a serious and an incapacitating disease. It is still under-estimated and under-treated throughout the world, particularly in sub-Saharan Africa. Doppler ultrasound, and in particular ankle brachial index (ABI), can be used to detect it. The aim was to determine the prevalence of PAD to study the clinical and ultrasonographic aspects and to identify the determining factors.
Patients and Methods: This was a descriptive and analytical study over a period of 5 years, including a total of 782 diabetic patients hospitalised in the diabetology department of the CHU la Reference Nationale.
Results: Among the 782 patients, 166 (21.2%) had an ABI < 0.9 reflected the PAD and 72 (9.2%) had an ABI > 1.3, suggestive of mediacalcosis. PAD of the lower limb was mild in 102 patients (61.4%), moderate in (26.3%) and severe in (12.3%). The mean age of the arteritic patients was 56.4 ± 10.2 years. Male gender predominated (59.6%) with a sex ratio of 1.6. All patients had type 2 diabetes (100%). The mean duration of diabetes was 13 ± 5.9 years. The majority of our patients with arterial disease had diabetes for at least 10 years (54.2%). The other cardiovascular in this population were obesity (45.2%), followed by hypertension and dyslipidaemia (32.5%). Diabetes was unbalanced (HbA ≥7%) in the majority of cases (75.3%). Clinically, the majority of patients had a trophic disorder (68%). Asymptomatic patients accounted for 24.6% of cases and those with intermittent claudication for 7.4%. Duplex doppler of the lower limbs showed that all patients with PAD had atheromatous lesions. The distal location was predominantly in the tibial arteries (54.8%). The determinants of PAD in this diabetic population were hypertension (p = 0.01) and obesity (p = 0.01).
Conclusion: In our series, PAD was often discovered at an advanced stage, with a non-negligible prevalence. The determining factors found were hypertension and obesity. Screening and control of major cardiovascular risk factors is a priority in the management of this disease.
(Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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