, Volume 38, Issue 1, pp 86–96

Peripheral arterial disease in relation to glycaemic level in an elderly Caucasian population: the Hoorn Study

  • P. J. Beks
  • A. J. C. Mackaay
  • J. N. D. de Neeling
  • H. de Vries
  • L. M. Bouter
  • R. J. Heine

DOI: 10.1007/BF02369357

Cite this article as:
Beks, P.J., Mackaay, A.J.C., de Neeling, J.N.D. et al. Diabetologia (1995) 38: 86. doi:10.1007/BF02369357


We investigated the cross-sectional association between peripheral arterial disease and glycaemic level in an age, sex, and glucose tolerance stratified random sample from a 50–74-year-old Caucasian population. Subjects treated with oral hypoglycaemic agents or insulin were classified as having known diabetes mellitus (KDM) (n=67). Using two oral glucose tolerance tests, and based on World Health Organisation criteria, all other participants were categorized as having a normal (NGT) (n=288), an impaired (IGT) (n=170), or a diabetic (NDM) (n=106) glucose tolerance. Prevalence rates of ankle-brachial pressure index less than 0.90 were 7.0%, 9.5%, 15.1% and 20.9% in NGT, IGT, NDM and KDM subjects, respectively (chi-square test for linear trend:p<0.01). Prevalence rates ofany peripheral arterial disease (ankle-brachial pressure index <0.90, at least one monophasic or absent Doppler flow curve or vascular surgery) were 18.1%, 22.4%, 29.2% and 41.8% in these categories (chi-square test for linear trend:p<0.0001). The prevalence ofany peripheral arterial disease was higher in KDM and NDM than in NGT (p<0.03,p<0.0001, respectively), whereas no statistically significant difference was demonstrated between IGT and NGT. The same applied when using the anklebrachial pressure index criterion. Logistic regression analyses showed thatany arterial disease was significantly associated with HbA1c, fasting and 2-h postload plasma glucose after correction for cardiovascular risk factors (odds ratios and 95% confidence intervals 1.35; 1.10–1.65 per %, 1.20; 1.06–1.36 and 1.06; 1.01–1.12 per mmol/l, respectively), whereas it was not associated with fasting and 2-h post-load specific insulin. Ankle-brachial pressure indices were not associated with either plasma glucose parameters or insulin in univariate or multivariate analyses. In conclusion, parameters of glucose tolerance are independently associated withany peripheral arterial disease, whereas insulin is not. [Diabetologia (1995) 38: 86–96]

Key words

Non-insulin-dependent diabetes mellitusimpaired glucose tolerancespecific insulinperipheral arterial diseaseepidemiologypopulation-based surveyCaucasians



Normal glucose tolerance


impaired glucose tolerance


newly-diagnosed diabetes mellitus


known diabetes mellitus (=using hypoglycaemic medication)


peripheral arterial disease


(systolic) ankle-brachial pressure index


odds ratio; 95% CI, 95% confidence interval


waist/hip ratio

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • P. J. Beks
    • 1
  • A. J. C. Mackaay
    • 2
  • J. N. D. de Neeling
    • 1
  • H. de Vries
    • 1
    • 3
  • L. M. Bouter
    • 1
    • 4
  • R. J. Heine
    • 1
    • 5
  1. 1.Institute for Research in Extramural MedicineVrije UniversiteitAmsterdamThe Netherlands
  2. 2.Department of Vascular SurgeryAcademic Hospital of the Vrije UniversiteitAmsterdamThe Netherlands
  3. 3.Department of General Practice and Nursing Home MedicineVrije UniversiteitAmsterdamThe Netherlands
  4. 4.Department of Epidemiology and BiostatisticsVrije UniversiteitAmsterdamThe Netherlands
  5. 5.Department of Internal MedicineAcademic Hospital of the Vrije UniversiteitAmsterdamThe Netherlands