Common and contrast determinants of peripheral artery disease and diabetic peripheral neuropathy in North Central Nigeria

BackgroundPeripheral artery disease (PAD) and diabetic peripheral neuropathy (DPN) are two of the leading causes of non-traumatic amputation worldwide with tremendous negative effects on the quality of life, psychosocial well-being of persons with diabetes mellitus; and a great burden on health care expenditure. It is therefore imperative, to identify the common and contrast determinants of PAD and DPN in order to ease adoption of common and specific strategies for their early prevention.MethodsThis was a multi-center cross-sectional study which involved the consecutive enrolment of one thousand and forty (1040) participants following consent and waiver of ethical approval. Relevant medical history, anthropometric measurements, other clinical examinations including measurement of ankle-brachial index (ABI) and neurological examinations were undertaken. IBM SPSS version 23 was used for statistical analysis and logistic regression was used to assess for the common and contrast determinants of PAD and DPN. Significance level used was p < 0.05.ResultsMultiple stepwise logistic regression showed that common predictors of PAD vs DPN respectively include age, odds ratio (OR) 1.51 vs 1.99, 95 % confidence interval (CI) 1.18–2.34 vs 1.35–2.54, p = 0.033 vs 0.003; duration of DM (OR 1.51 vs 2.01, CI 1.23–1.85 vs 1.00–3.02, p = <.001 vs 0.032); central obesity (OR 9.77 vs 1.12, CI 5.07–18.82 vs 1.08–3.25, p = <.001 vs 0.047); poor SBP control (OR 2.47 vs 1.78, CI 1.26–4.87 vs 1.18–3.31, p = .016 vs 0.001); poor DBP control (OR 2.45 vs 1.45, CI 1.24–4.84 vs 1.13–2.59, p = .010 vs 0.006); poor 2HrPP control (OR 3.43 vs 2.83, CI 1.79–6.56 vs 1.31–4.17, p = <.001 vs 0.001); poor HbA1c control (OR 2.59 vs 2.31, CI 1.50–5.71 vs 1.47–3.69, p = <.001 vs 0.004).Common negative predictors or probable protective factors of PAD and DPN respectively include statins (OR 3.01 vs 2.21, CI 1.99–9.19 vs 1.45–3.26, p = .023 vs 0.004); and antiplatelets (OR 7.14 vs 2.46, CI 3.03–15.61 vs 1.09–5.53, p = .008 vs 0.030). However, only DPN was significantly predicted by female gender (OR 1.94, CI 1.39–2.25, p = 0.023), height (OR 2.02, CI 1.85–2.20, p = 0.001), generalized obesity (OR 2.02, CI 1.58–2.79, p = 0.002), and poor FPG control (OR 2.43, CI 1.50–4.10, p = 0.004)ConclusionCommon determinants of PAD and DPN included age, duration of DM, central obesity, and poor control of SBP, DBP, and 2HrPP control. Additionally, the use of antiplatelets and statins use were common inverse determinants of PAD and DPN which means they may help protect against PAD and DPN. However, only DPN was significantly predicted by female gender, height, generalized obesity, and poor control of FPG.