The correlation between transcutaneous oxygen tension and microvascular complications in type 2 diabetic patients

Huang, Ke; Ma, Yufei; Wang, Jie; Shi, Shou‐Sen; Fu, Liujun; Liu, Jie; Li, Liping; Lu, Haibo; Liang, Xuezheng; Liu, Yanyun; Jiang, Hong

doi:10.1016/j.jdiacomp.2017.02.006

Cited by 11 publications

(8 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Biochemical investigation of the current study revealed significant elevation of fasting, postprandial blood glucose, glycated hemoglobin and serum Creatinine in diabetic groups compared to control one. These findings were reported previously [24] , elevated levels of HbA1c were linked to the development of microvascular events in type 2 diabetic patients [25] , also impairment of renal functions has been linked to atherosclerosis [26] .…”

Section: Discussionsupporting

confidence: 89%

Ankle Brachial Index As A Monitor of Diabetes Type 2 Microvascular Complications

Mahmoud¹,

Ahmed

2019

The Medical Journal of Cairo University

View full text Add to dashboard Cite

Background: Peripheral Artery Disease (PAD) has been linked with diabetic microvascular complications. However, many patients do not show typical symptoms. Ankle-Brachial Index (ABI) is reported to be a simple and useful method to estimate cardiovascular risks. Aim of Study: To determine whether Ankle-brachial index could be a useful monitor of development of micro vascular complications in type 2 diabetes. Patients and Methods: A cross sectional study included 93 patients, classified into two groups: Group I (control group) consistsed of 10 healthy individuals. Group II (patient group): Consisted of 83 diabetes type 2 patients diagnosed according to ADA criteria; who were further subdivided according to presence or absence of microvascular complications into two groups: Group IIA: 10 diabetics without microangiopathy and Group IIB: 73 Diabetics with microangiopathy. All the study members were subjected to clinical evaluation, fundus examination, serial measurement of blood pressure, fasting & postprandial blood glucose, HbA1c, serum creatinine, urinary albumin and ABI. Results: Our results showed significant higher BMI and lower ABI in diabetic groups compared to control (p<0.05); where fasting blood glucose, postbrandial blood glucose, HbA1c and serum creatinine were significantly elevated diabetic groups compared to control (p<0.05). A significant negative correlations (p<0.000) between BMI, HbA1c and duration of DM with ABI. The incidance of microvacular complications (retinopathy, nephropathy & neuropathy) was significantly higher (p 0.00) in complicated diabetic group (Group IIB) compared to control and IIA groups. The average ABI was significantly lower (p<0.05) among complicated diabetic group (Group IIB) regarding retinopathy (proliferative & non proliferative), nephropathy (micro & macroalbuminria) and neuropathy (mild, moderate & sever). Conclusion: Low ABI is common in patients with T2D. The ABI is a simple, reproducible, and cost-effective screening test for diagnosing microvascular complications in diabetes type 2 patients. ABI screening should be performed in diabetic population for early evaluate of microvascular complications.

show abstract

Section: Discussionsupporting

confidence: 89%

Ankle Brachial Index As A Monitor of Diabetes Type 2 Microvascular Complications

Mahmoud¹,

Ahmed

2019

The Medical Journal of Cairo University

View full text Add to dashboard Cite

show abstract

“…One possible explanation could be that a low TcPO 2 on the foot might serve as a marker for impaired microcirculation in general, with a higher burden of microvascular complications. It has previously been shown by Huang et al [27], a significant negative association between TcPO 2 and microvascular events (albuminuria and distal polyneuropathy) in type 2 diabetes patients, with a tenfold risk of microvascular complications when TcPO 2 was < 50 mmHg. Similar, our study demonstrated a significant association between a low TcPO 2 and renal impairment, and a low eGFR did also independently associated with mortality, results previously shown by many [28–30].…”

Section: Discussionmentioning

confidence: 86%

Transcutaneous oxygen pressure as a predictor for short-term survival in patients with type 2 diabetes and foot ulcers: a comparison with ankle–brachial index and toe blood pressure

2018

View full text Add to dashboard Cite

AimsAnkle–brachial index (ABI) is the most commonly used test when diagnosing peripheral vascular disease and is considered a marker for cardiovascular risk. Transcutaneous oxygen pressure (TcPO2), a test associated with microvascular function, has in several studies shown better correlation with diabetic foot ulcer (DFU) healing. Whether a low TcPO2 could be a marker for mortality in the high-risk population of DFU patients has not been evaluated before. The aim of this study was to evaluate the predictive value of TcPO2 in comparison with ABI and toe blood pressure (TBP) on 1-year mortality in type 2 diabetes patients with DFU.MethodsType 2 diabetes patients aged ≤ 90 years, with one DFU who attended our multidisciplinary DFU-unit during year 2013–2015 and were screened with TcPO2, ABI and TBP were retrospectively evaluated. One-year mortality was assessed from the national death register in Sweden.ResultsA total of 236 patients (30% women) with a median age of 76 (69–82) years were evaluated in this study. Within 1 year, 14.8% of the patients died. TcPO2 < 25 mmHg was associated with a higher 1-year mortality compared with TcPO2 ≥ 25 mmHg (27.7 vs. 11.6%, p = 0.003). TBP and ABI did not significantly influence 1-year mortality. In a Cox regression analysis adjusted for confounders, TcPO2 was independently predicting 1-year mortality with a hazard ratio for TcPO2 < 25 mmHg of 2.8 (95% CI 1.34–5.91, p = 0.006).ConclusionsThis study indicates that a low TcPO2 is an independent prognostic marker for 1-year mortality among patients with type 2 diabetes and DFU.

show abstract

“…Further, coexisting microvascular complications, such as diabetic kidney disease and neuropathy, often contributes to the poor prognosis both concerning ulcer healing and survival. Previous studies have shown that a low TcPO 2 has been associated with a higher burden of other microvascular complications as well as an increased risk of major cardiovascular events [ 12 , 21 ]. In our study, patients with pathological ABI and a low TcPO 2 were more likely to have reduced renal function, result consistent with other studies [ 22 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

The combined impact of ankle–brachial index and transcutaneous oxygen pressure on mortality in patients with type 2 diabetes and foot ulcers

Fagher

Löndahl

2021

Acta Diabetol

View full text Add to dashboard Cite

Aims A diabetic foot ulcer (DFU) is associated with increased cardiovascular risk and mortality, independently of ulcer etiology (ischemic, neuro-ischemic or neuropathic). Ankle–brachial index (ABI) is the most commonly used test when diagnosing peripheral macrovascular disease and is a well-known marker for increased cardiovascular risk. Transcutaneous oxygen pressure (TcPO2) is considered to better evaluate microvascular function and has in previous studies shown correlations with both wound healing and survival. The aim of this study was to evaluate the combined impact of a low TcPO2 (<30 mmHg) and a pathological ABI (<0.9 or ≥1.4) on three-year mortality in patients with DFU. Methods Type 2 diabetes patients aged <90 years, with at least one DFU who underwent vascular assessment with ABI and TcPO2 were screened for participation. The primary endpoint was mortality after three years, assessed from the National Death Registry in Sweden. Results The study enrolled 235 participants with a median age of 76 years. Individuals with either an abnormally high or low ABI in combination with a low TcPO2 had the worst survival rates, with three-year mortality of 54%, compared to 42% in those with one abnormal variable (either ABI or TcPO2), and 21% in those with normal ABI and TcPO2. Conclusions Combining ABI and TcPO2 when risk stratifying DFU patients seems to provide additional predictive information, not only concerning ulcer healing and limb salvage, but also on survival.

show abstract

The correlation between transcutaneous oxygen tension and microvascular complications in type 2 diabetic patients

Cited by 11 publications

References 21 publications

Ankle Brachial Index As A Monitor of Diabetes Type 2 Microvascular Complications

Ankle Brachial Index As A Monitor of Diabetes Type 2 Microvascular Complications

Transcutaneous oxygen pressure as a predictor for short-term survival in patients with type 2 diabetes and foot ulcers: a comparison with ankle–brachial index and toe blood pressure

The combined impact of ankle–brachial index and transcutaneous oxygen pressure on mortality in patients with type 2 diabetes and foot ulcers

Contact Info

Product

Resources

About