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The association between diabetes mellitus and the prevalence of intermittent claudication: the HUNT study

Department of Community Medicine and General Practice, Norwegian University of Science and Technology, University Medical Center, Trondheim, Norway; Department of Surgery, Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, University Medical Center, Trondheim, Norway

Lars J Vatten

Department of Community Medicine and General Practice, Norwegian University of Science and Technology, University Medical Center, Trondheim, Norway

Hans O Myhre

Department of Surgery, Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, University Medical Center, Trondheim, Norway hans.myhre{at}ntnu.no

Abstract

The objective of this study was to investigate the association between diabetes mellitus (DM) and the prevalence of intermittent claudication (IC). Between 1995 and 1997, all residents aged 20 years or older in Nord-Trøndelag County, Norway were mailed an invitation to participate in a health survey (HUNT 2). A total of 19,712 participants aged 40–69 years old completed and returned the questionnaire included with the invitation. They also attended an examination where brachial blood pressure was measured and non-fasting venous blood was collected. The venous blood sample was subsequently analysed for concentrations of blood lipids. Responses to 12 questions on IC were previously tested against ankle blood pressure measurements (ABPI < 0.9) and the algorithm with the best test properties was used to identify individuals with IC. Participants reported a history of DM by simple questions in the questionnaire. Logistic regression analysis was then used to compute age-adjusted prevalence odds ratios for the association between exposure variables and the prevalence of IC. Potential confounding by smoking, blood lipids and brachial blood pressure was investigated in multivariate analyses. For both sexes IC was more common in individuals with DM (OR_women = 3.8, CI, 1.9–7.6; OR_men = 2.8, CI, 1.4–5.8) compared to participants without DM. Adjustment for smoking, blood lipids and brachial blood pressure did not substantially change these results. In conclusion, the prevalence of IC was more than three times higher in patients with DM compared to non-diabetic participants.

Key Words: diabetes mellitus • epidemiology • intermittent claudication • prevalence

Vascular Medicine, Vol. 13, No. 4, 239-244 (2008)
DOI: 10.1177/1358863X08094800


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