Epidemiology Of Chronic Obstructive Arterial Disease Of The Lower Limbs And Diabetic Patients At The University Hospital Of Cotonou (Benin)

The aims of this study were to determine the prevalence of chronic obstructive arterial disease of the lower limbs and to identify the factors which contribute to its occurrence in a population of adult African francophone diabetics.This was a prospective study which included all consenting diabetics systematically over a 6 month period at the out patient clinic or during hospital admission. Patients with incomplete data were excluded. An ankle systolic pressure index of less than 0.9 was required for the diagnosis of obstructive arterial disease. Demographic parameters, the characteristics of the diabetes, the quality of blood sugar control, the presence of classical cardiovascular risk factors and the results of their treatment, the nature and distribution of the arterial lesions on ultrasonography were all studied. A univariate analysis and a multivariate analysis of their correspondences were undertaken to determine the correlation coefficients.The prevalence of arterial disease of the lower limbs in the 102 diabetics retained for the study (average age 53 years) was 33.3%. The arterial disease was distal in 47% of cases and diffuse in 26.5% of cases. The arterial wall was calcified in 19.6% of cases. In univariate analysis only age was correlated with arterial disease (p= 0.04), the duration of diabetes tended to be related (p= 0.07). In multi-factorial analysis of correspondences with other factors, hypertension, hyperlipidaemia and multiple cardiovascular risk factors seemed to be correlated with arterial disease of the lower limbs.Therefore, arterial disease of the lower limbs is very common and an early complication of diabetic patients in Benin. Predisposing factors were age and, probably, duration of diabetes, hypertension, hyperlipidaemia and multiple cardiovascular risk factors.