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Adou C, Magne J, Gazere N, Aouida M, Chastaingt L, Aboyans V. Global epidemiology of lower extremity artery disease in the 21st century (2000-21): a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:803-811. [PMID: 38079162 DOI: 10.1093/eurjpc/zwad381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 02/06/2024]
Abstract
AIMS The epidemiology of lower extremity artery disease (LEAD) is evolving. This meta-analysis of aggregate data aimed to (i) determine the global prevalence of LEAD and by regions in the 21st century and (ii) update the associated risk factors in this period. METHODS AND RESULTS A systematic literature review was performed through PubMed, Cochrane, Scopus, Science Direct, and Google Scholar databases, restricted to general population studies between January 2000 and September 2021, with LEAD defined by a low (≤0.90) ankle-brachial index. The Newcastle-Ottawa Scale was used to evaluate the quality of the articles before data extraction. Due to high heterogeneity, the random effect model was applied to this meta-analysis. Among 1418 references, 38 studies (127 961 participants) were retained. The global prevalence in adults, mostly ≥40 years, was estimated at 9.7% [95% confidence interval (CI): 7.1-12.4], higher in women (10.2%) than in men (8.8%), increasing sharply with age. The highest prevalence was found in South-Central Asia (14.5%) and the lowest in North America (5.6%). Significant associations were found between LEAD and current [odds ratio (OR) = 1.9, 95% CI: 1.4-2.5] and past smoking (OR = 1.6, 95% CI: 1.3-1.9) and between LEAD and diabetes (OR = 2.3, 95% CI: 2.0-2.8). Hypertension was significantly associated with LEAD (OR = 2.3, 95% CI: 1.9-2.8) and in particular in South America (OR = 4.0). Obesity (OR = 1.5, 95% CI: 1.2-1.8) and hypercholesterolaemia ≥200 mg/dL (OR = 1.9, 95% CI: 1.3-2.8) were also significantly associated with LEAD. CONCLUSION This meta-analysis highlights a currently high prevalence of LEAD worldwide, with substantial differences in global regions and between sexes. The strongest associations were found with metabolic risk factors.
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Affiliation(s)
- Caroline Adou
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
| | - Julien Magne
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
| | - Nana Gazere
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
| | - Maissa Aouida
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
| | - Lucie Chastaingt
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
- Department of Vascular Surgery and Vascular Medicine, Dupuytren University Hospital, Limoges, France
| | - Victor Aboyans
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
- Department of Cardiology, Dupuytren University Hospital, 16 rue Bernard Descottes, 87042 Limoges, France
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Ndong A, Konta B, Tendeng JN, Dia DG, Dia AD, Diao ML, Diallo AC, Diop S, Gouamba BM, Dia DA, Diedhiou M, Dieng M, Fall ML, Nyemb PMM, Konaté I. Factors Associated with Foot Lesions in Diabetic Patients at Saint-Louis Hospital (Senegal): A Case-Control Study Protocol. Int J Surg Protoc 2021; 25:16-20. [PMID: 34013140 PMCID: PMC8114845 DOI: 10.29337/ijsp.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Diabetes prevalence has increased over the past years. In Senegal, this prevalence is 4% in the general population. However, the region of Saint-Louis (in the north of the country) has the highest rate with 10.4%. The main prognosis problem is the occurrence foot lesions that can lead to lower-limbs amputation. Diabetic foot is a real public health issue, due to its economic burden and its serious repercussions on patients, leading to poor quality of life. The objective of this case-control study is to identify factors associated with foot lesions in diabetic patients. Methods and analysis: It will be a case-control study from January to December 2021. The patients will be recruited from the departments of general surgery, internal medicine, and emergency. An univariate then multivariate analysis (logistic regression) will allow us to select the variables associated with foot lesions in our study population. The parameters included in the logistic regression will be those with a p < 0.20 in the univariate analysis. Finally, a binary logistic regression analysis (with the calculation of Odds Ratios (OR) with confidence intervals (CI)) according to the backward stepwise method will identify the factors independently associated to foot lesions in diabetic patients. Ethics and dissemination: This research protocol will be submitted to the Ethics Committee of our institution for approval. The knowledge of factors causing diabetic foot will help to communicate with policymakers to raise the awareness in our community. Finally, it will help to prevent lower limb amputations. Highlights
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Affiliation(s)
- A Ndong
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
| | - B Konta
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
| | - J N Tendeng
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
| | - D G Dia
- Department of Internal Medicine, Gaston Berger University of Saint-Louis, Senegal
| | - A D Dia
- Department of Internal Medicine, Gaston Berger University of Saint-Louis, Senegal
| | - M L Diao
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
| | - A C Diallo
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
| | - S Diop
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
| | - B M Gouamba
- Department of Internal Medicine, Gaston Berger University of Saint-Louis, Senegal
| | - D A Dia
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
| | - M Diedhiou
- Department of Anaesthesiology, Gaston Berger University of Saint-Louis, Senegal
| | - M Dieng
- Department of Anaesthesiology, Gaston Berger University of Saint-Louis, Senegal
| | - M L Fall
- Department of Anaesthesiology, Gaston Berger University of Saint-Louis, Senegal
| | - P M Ma Nyemb
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
| | - I Konaté
- Department of Surgery, Gaston Berger University of Saint-Louis, Senegal
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Houehanou YC, Mizéhoun-Adissoda C, Amidou S, Désormais I, Houénassi M, Preux PM, Marin B, Houinato D, Lacroix P. Feasibility of a cardiovascular cohort in a Sub-Saharan Africa community: preliminary report of the pilot project TAHES (Tanvè Health Study) in Benin. Glob Health Action 2018; 10:1270528. [PMID: 28498739 PMCID: PMC5496170 DOI: 10.1080/16549716.2017.1270528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Faced with the growing burden of cardiovascular disease (CVD) including atherosclerotic in Sub-Saharan Africa (SSA), the development of appropriate prediction tools, based on large cohorts, appears useful for prevention. OBJECTIVE The objective of the pilot project TAHES (Tanvè Health Study) was to explore the feasibility of a large cohort study focused on CVD and risk factors in Benin. METHODS We implemented a prospective cohort over 2 years. The sample consisted of all people aged 25 years or older who had lived for at least the previous 6 months in the villages of Tanvè or Dékanmè. At baseline in February 2015, behaviours and medical histories were recorded using a standardized questionnaire adapted from the WHO Steps instrument; screening questionnaires for angina, claudication, congestive heart failure, and stroke were applied; anthropometric measures and fasting capillary blood glucose were taken. All participants were included in the follow-up phase. Surveillance of target CVD and deaths was implemented through a medical and a community network. RESULTS A total of 1,195 participants were enrolled at baseline; women represented 65.5% and the median age was 39 years. The high participation rate (91.4%), the quality of baseline data, and the functionality of the events surveillance network over 8 months indicated good perspective for the feasibility of a large cohort. We recorded a 3.8% prevalence of daily smoking, 3.6% of harmful use of alcohol, 10.7% of obesity, 25.5% of high blood pressure, and 3.5% of diabetes. Prevalence of angina pectoris (2.7%), intermittent claudication (2.0%), congestive heart failure (0.9%), and stroke survival with motor impairment (3‰) were also recorded. Ten deaths occurred during the first 8 months, all within households; a cardiovascular cause was suspected in four cases. CONCLUSION These preliminary results support the feasibility of establishing a cohort in Benin. It would require technical and resource support.
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Affiliation(s)
- Yessito Corine Houehanou
- a U1094, Tropical Neuroepidemiology , INSERM , Limoges , France.,b UMR-S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology , University Limoges , Limoges , France.,c Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology , University of Abomey-Calavi , Cotonou , Bénin
| | - Carmelle Mizéhoun-Adissoda
- a U1094, Tropical Neuroepidemiology , INSERM , Limoges , France.,b UMR-S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology , University Limoges , Limoges , France.,c Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology , University of Abomey-Calavi , Cotonou , Bénin
| | - Salimanou Amidou
- a U1094, Tropical Neuroepidemiology , INSERM , Limoges , France.,b UMR-S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology , University Limoges , Limoges , France.,c Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology , University of Abomey-Calavi , Cotonou , Bénin
| | - Iléana Désormais
- a U1094, Tropical Neuroepidemiology , INSERM , Limoges , France.,b UMR-S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology , University Limoges , Limoges , France.,d Vascular Medicine Unit , CHU Limoges , Limoges , France
| | | | - Pierre-Marie Preux
- a U1094, Tropical Neuroepidemiology , INSERM , Limoges , France.,b UMR-S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology , University Limoges , Limoges , France.,d Vascular Medicine Unit , CHU Limoges , Limoges , France
| | - Benoit Marin
- a U1094, Tropical Neuroepidemiology , INSERM , Limoges , France.,b UMR-S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology , University Limoges , Limoges , France.,f Functional Unit of Clinical Research and Biostatistics , CHU Limoges , Limoges , France
| | - Dismand Houinato
- a U1094, Tropical Neuroepidemiology , INSERM , Limoges , France.,c Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology , University of Abomey-Calavi , Cotonou , Bénin.,g Neurology Unit , CNHU Cotonou , Cotonou , Bénin
| | - Philippe Lacroix
- a U1094, Tropical Neuroepidemiology , INSERM , Limoges , France.,b UMR-S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology , University Limoges , Limoges , France.,d Vascular Medicine Unit , CHU Limoges , Limoges , France
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Konin C, Essam N'loo AS, Adoubi A, Coulibaly I, N'guetta R, Boka B, N'djessan JJ, Koffi J, Yao H, Angoran I, Adoh M. [Peripheral arterial disease of the lower limbs in African diabetic patients: ultrasonography and determining factors]. JOURNAL DES MALADIES VASCULAIRES 2014; 39:373-381. [PMID: 25234283 DOI: 10.1016/j.jmv.2014.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 05/28/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Diabetic peripheral arterial disease (PAD) of the lower limbs is underdiagnosed. METHODOLOGY This was a prospective study conducted over a six-month period from November 2012 to April 2013. A total of 308 diabetic patients were included from three diabetes centers in Abidjan (Ivory Coast). AIM To screen for PAD of the lower limbs in a diabetic population and to identify the determining factors. RESULTS Among the 308 patients, the ankle-brachial index (ABI) was<0.9 in 68 (22.07%) patients considered to have PAD; the ABI was>1.3 in 56 (18.2%) patients who had suspected mediacalcosis. The average age of the PAD patients was 60.2 years. Female gender predominated (55.9%). The mean duration of diabetes was 9.6 years: 97.1% type 2 diabetes. The other cardiovascular risk factors in this population were hypertension (58.8%) and dyslipidemia (40.9%). Smoking was present in 29.4% of patients and obesity in 23.9%. PAD of the lower limbs was mild in 46 patients (67.6%), moderate in 16 (23.5%) and severe in 6 (8.8%). Duplex Doppler commonly showed lesions of the tibial arteries. Determining factors of diabetic PAD of the lower limbs were hypertension (58.8% vs 36.6%; OR=2.46; 95% CI: 1.13-5.36; P=0.034) and dyslipidemia (40.9% vs 8.3%; OR=7.6; 95% CI: 2.31-25.08; P=0.0009). For mediacalcosis, male gender (71.5% vs 39.7; OR=0.26 95% CI/0.10-0.64. P=0.004) was the only factor identified. CONCLUSION Hypertension and dyslipidemia were predictive factors for diabetic PAD of the lower limbs in our African population.
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Affiliation(s)
- C Konin
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire.
| | | | - A Adoubi
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - I Coulibaly
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - R N'guetta
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - B Boka
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - J J N'djessan
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - J Koffi
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - H Yao
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - I Angoran
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
| | - M Adoh
- Institut de cardiologie d'Abidjan, Abidjan, Côte d'Ivoire
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Behar T, Bosson JL, Galanaud JP, Thoret S, Rolland C, Bura-Rivière A, Quéré I, Laroche JP. [Prevalence and risk factors of peripheral arterial disease in an outpatient screening campaign]. ACTA ACUST UNITED AC 2013; 38:22-8. [PMID: 23352626 DOI: 10.1016/j.jmv.2012.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/07/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Peripheral arterial disease (PAD) is an important predictor of cardiovascular disease with major medico-economic consequences. However, systematic screening of asymptomatic patients free from history of cardiovascular disease is debated. OBJECTIVE Determining the prevalence, risk factors for PAD in a population of outpatients at intermediate or high-risk of cardiovascular disease, free from history of cardiovascular disease to assess the potential impact of PAD screening in such groups of patients. METHODS Multicenter 1-day screening program of PAD conducted from 2008 to 2010 in a population defined by diabetes plus age greater than 50 years, positive active smoking status, or age greater than 70 years. PAD was defined as an ankle-brachial index (ABI) less than 0.9 measured as follows: lowest systolic ankle pressure divided by highest systolic arm pressure. RESULTS Ten thousand six hundred and fourteen patients fulfilled study inclusion criteria: 16.7% (n = 1774) exhibited an ABI less than 0.9 and 3.8% (n = 407) an ABI less than 0.7. ABI greater than 1.3 was found in 7.7% of patients (n = 818). Age greater than 70 years, male gender, active smoking status, hypertension and diabetes (treated) were independent risk factors for PAD. CONCLUSION Primary prevention outpatient screening of a population with intermediate or high cardiovascular risk can identify numerous patients with PAD. The medical impact in terms of cardiovascular mortality and morbidity of such a screening needs to be assessed.
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Affiliation(s)
- T Behar
- EA 2992, service de médecine vasculaire, département de médecine interne, CHU de Montpellier, université Montpellier 1, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
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