Gender Difference of Risk Factors for Peripheral Arterial Disease in African-American Diabetic Patients: Jackson Heart Study

Epidemiological studies have well documented that type II diabetes mellitus (DM) and obesity are risk factors for both peripheral arterial disease (PAD) and coronary heart disease (CHD). Given the gender differences in obesity and DM prevalence in the Jackson Heart Study (JHS), it is important to assess gender differences in PAD prevalence and risk factors for PAD among African-Americans participants in the JHS who have a diagnosis of DM.

There were 968 patients who met the criteria for a diagnosis of DM in the Jackson Heart Study (men: 315, women: 653), average age 60 years. PAD was diagnosed by an ankle-brachial Index (ABI) <0.9, having intermittent claudication, or having other arterial revascularization or bypass. Patients with ABI>1.4 were excluded in the analysis because the values would indicate non-compressible vessels. Fifteen percent had PAD, more men had PAD then women (18% versus 13%). Risk factors included age, gender, Body Mass Index (BMI), waist circumference (WC), smoking, hypertension insulin therapy, systolic (SBP) and diastolic blood pressures (DBP), fasting glucose, total cholesterol (TCL), high-density lipoproteins (HDL) cholesterol, low-density lipoproteins (LDL) cholesterol, A1C, and uric acid (UA). A logistic regression model with PAD as a dependent variable found BMI, smoking, UA, SBP, and DBP as significant independent risk factors. Sex-specific logistic regression models showed BMI, smoking, UA, and SBP as risk factors for men and UA, SBP, and DBP for women.

Preliminary results suggest that there are gender differences in the risk factors for PAD among African-Americans who have a diagnosis of DM.