Association of glucose metabolism, smoking and cardiovascular risk factors with incident peripheral arterial disease: The DESIR study
Section snippets
Sample selection
This study is based on data collected from a French cohort, Data from an Epidemiological Study of the Insulin Resistance Syndrome (DESIR). The population, methods and response rate of the DESIR study are found in detail elsewhere [13]. In brief, the DESIR study was based on a volunteer population from 10 health examination centres in the western central part of France. Participants were insured by the French Social Security system, which offers periodic health examinations free of charge. The
Results
The incidence of PAD by diabetes status is shown in Table 1. Among those with normal fasting glucose (NFG) and free of PAD at baseline, the 6-year incidence of PAD (defined by ABPI < 0.9 and or claudication present) was 5.1%. In those with IFG at baseline the incidence of PAD was 4.9% and among those with diabetes at baseline the incidence of PAD was 9.8%. The incidence of PAD among those who maintained NFG over 6 years was 4.7% and among those who progressed to diabetes over the 6 years, the
Discussion
This is one of the few longitudinal studies of PAD to be undertaken and one of the very few studies to look across categories of glucose metabolism [10]. This is an important study, as although PAD is a component of macrovascular disease, and is well known to occur more commonly among those with diabetes, few studies have observed the natural history of the disease [17]. In the present study the six-year incidence of PAD was 5.1% among those with NFG, 4.9% among those with IFG and 9.8% among
Acknowledgements
This work was supported by co-operative contracts between the Institut National de la Santé et de la Recherche Médicale (INSERM) and la Caisse Nationale de l’Assurance Maladies des Travailleurs Salariés (CNAMTS) (contract no. 3AM004) and Novartis Pharma (convention no. 98297), by INSERM Réseaux en Santé Publique (contract nos. 494003 and 4R001C) and by INSERM Interactions entre les determinants de la santé (contract no. 4D002D), by the Association Diabète Risque Vasculaire, the Fédération
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The DESIR Study Group: INSERM U258: B. Balkau, P. Ducimetière, E. Eschwège; INSERM U367: F. Alhenc-Gelas; CHU D’ANGERS: Y. Gallois, A. Girault; Hôpital Bichat: F. Fumeron, M. Marre; Centres D’examens de Santé du Réseau 9: Alençon, Angers, Blois, Caen, Chartres, Chateauroux, Cholet, Le Mans, Orléans, Tours; Institut de Recherche en Médecine Générale: J. Cogneau; Medecins Géneralistes des Départements; Institut Inter Régional Pour la Santé: C. Born, E. Cacès, M. Cailleau, J.G. Moreau, F. Rakotozafy, J. Tichet, S. Vol.