Journal Article Epublish
PubMed: 40698289 DOI: 10.1016/j.ijcrp.2025.200469
Peripheral artery disease In West Africans with diabetes: a risk factor profile analysis.
Int J Cardiol Cardiovasc Risk Prev 26:200469
Authors: Joachim Amoako, Matthan Fayia Saa, Emmanuel Bannerman-Williams, Anastasia Naa Koshie Bruce, Maame Boatemaa Ansong, Alexander Danquah, Abraham Ablorh, Wills Nii Adjetey Kwaw, Michael Adjei, Emmanuel K Awuttey, Isabella D Dakubo, Patience Akos Vormatu, Isaac Ekow Ennin, Charles Frederick Hayfron-Benjamin
Affiliations
- Department of Surgery, University of Ghana Medical School, Ghana.
- Department of Physiology, University of Ghana Medical School, Ghana. College of Health Sciences University of Liberia, Liberia.
- Department of Surgery, University of Ghana Medical School, Ghana. Departments of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Amsterdam, the Netherlands. Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
- Department of Physiology, University of Ghana Medical School, Ghana. Department of Anesthesia and Critical Care, Korle Bu Teaching Hospital and University of Ghana Medical School, Ghana.
- Department of Physiology, University of Ghana Medical School, Ghana.
- Department of Physiology, University of Ghana Medical School, Ghana. School of Medical Sciences, University of Cape Coast, Ghana.
- Department of Physiology, University of Ghana Medical School, Ghana. Department of Pediatrics, Korle Bu Teaching Hospital, Ghana.
- School of Medical Sciences, University of Cape Coast, Ghana.
- Department of Physician Assistantship Studies, School of Medical Sciences, Central University, Ghana.
- Departments of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Amsterdam, the Netherlands.
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
- Department of Anesthesia and Critical Care, Korle Bu Teaching Hospital and University of Ghana Medical School, Ghana.
- Department of Anesthesia and Intensive Care, University of Ghana Medical Centre, Ghana.
Abstract
Background
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.
Methods
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.
Results
The mean age, diabetes duration, and HbA 1c 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.
Conclusion
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.
MeSH
Diabetes Mellitus, Kidney Diseases, Hypertension, Kidney, Arteries, Cholesterol, Obesity, Risk Factors, Peripheral Arterial Disease, Obesity, Abdominal