SHORT REPORT
Ankle-brachial index and eicosapentaenoic acid/arachidonic acid ratio in smokers with type 2 diabetes mellitus
Kenta Okada 1, 2  
,  
 
 
More details
Hide details
1
Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, Shimotsuke-City, Japan
2
Nasu Chuoh Hospital, Otawara-City, Japan
3
Division of Community and Family Medicine, Jichi Medical University, Shimotsuke-City, Japan
CORRESPONDING AUTHOR
Kenta Okada   

Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-City, Tochigi 329-0498, Japan
Publish date: 2016-01-28
 
Tobacco Induced Diseases 2016;14(January):2
KEYWORDS
ABSTRACT
Background:
The ankle-brachial index (ABI) is an indicator of peripheral arterial damage and a low (ABI ≤ 1.0) or borderline (ABI = 1.00–1.09) value is associated with risk of cardiovascular disease events. A low ratio of serum eicosapentaenoic acid to arachidonic acid (EPA/AA) is also a risk factor for cardiovascular disease events. This study examined associations between the ABI and the EPA/AA ratio in smokers and non-smokers with type 2 diabetes mellitus (T2DM).

Findings:
Blood data including EPA, AA, and ABI were measured in smokers and non-smokers with T2DM enrolled at Jichi Medical University (n = 116, male 86 %, mean age 59 yr). The patients were classified into two groups according to their ABI level: <1.1 (low to borderline) or ≥1.1 (high). The EPA/AA ratio in smoking patients with ABI < 1.1 (n = 26; EPA/AA = 0.25) was significantly lower than in those with ABI ≥ 1.1 (n = 32; EPA/AA = 0.34; p = 0.03), but was not significantly different in non-smoking patients. The EPA/AA ratio was independently, significantly, and positively correlated with the ABI level (β = 0.41; p < 0.01) after adjusting for multiple variables only in smoking patients with T2DM.

Conclusions:
The EPA/AA ratio may be associated with subclinical peripheral arterial damage in smokers with T2DM. Further studies are warranted.

 
REFERENCES (21)
1.
Althouse AD, Abbott JD, Forker AD, Bertolet M, Barinas-Mitchell E, Thurston RC, et al. Risk factors for incident peripheral arterial disease in type 2 diabetes: results from the Bypass Angioplasty Revascularization Investigation in type 2 Diabetes (BARI 2D) Trial. Diabetes Care. 2014;37(5):1346–52.
 
2.
Yao ST, Hobbs JT, Irvine WT. Ankle systolic pressure measurements in arterial disease affecting the lower extremities. Br J Surg. 1969;56(9):676–9.
 
3.
Ouriel K, Zarins CK. Doppler ankle pressure: an evaluation of three methods of expression. Arch Surg. 1982;117(10):1297–300.
 
4.
Diehm C, Lange S, Darius H, Pittrow D, von Stritzky B, Tepohl G, et al. Association of low ankle brachial index with high mortality in primary care. Eur Heart J. 2006;27(14):1743–9.
 
5.
Kato A, Takita T, Furuhashi M, Kumagai H, Hishida A. A small reduction in the ankle-brachial index is associated with increased mortality in patients on chronic hemodialysis. Nephron Clin Pract. 2010;114(1):c29–37.
 
6.
Matsuzaki M, Yokoyama M, Saito Y, Origasa H, Ishikawa Y, Oikawa S, et al. Incremental effects of eicosapentaenoic acid on cardiovascular events in statin-treated patients with coronary artery disease. Circ J. 2009;73(7):1283–90.
 
7.
Domei T, Yokoi H, Kuramitsu S, Soga Y, Arita T, Ando K, et al. Ratio of serum n-3 to n-6 polyunsaturated fatty acids and the incidence of major adverse cardiac events in patients undergoing percutaneous coronary intervention. Circ J. 2012;76(2):423–9.
 
8.
Fujihara M, Fukata M, Odashiro K, Maruyama T, Akashi K, Yokoi Y. Reduced plasma eicosapentaenoic acid-arachidonic acid ratio in peripheral artery disease. Angiology. 2013;64(2):112–8.
 
9.
Okada K, Kotani K, Yagyu H, Ishibashi S. Eicosapentaenoic acid/arachidonic acid ratio and smoking status in elderly patients with type 2 diabetes mellitus. Diabetol Metab Syndr. 2014;6(1):85.
 
10.
Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005;45(1):142–61.
 
11.
Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011;80(1):17–28.
 
12.
Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res. 2002;25(3):359–64.
 
13.
Price JF, Tzoulaki I, Lee AJ, Fowkes FG. Ankle brachial index and intima media thickness predict cardiovascular events similarly and increased prediction when combined. J Clin Epidemiol. 2007;60(10):1067–75.
 
14.
Jin X, Ma JH, Shen Y, Luo Y, Su XF, Chen YY, et al. An analysis of the relationship between ankle-brachial index and estimated glomerular filtration rate in type 2 diabetes. Angiology. 2012;64(3):237–41.
 
15.
Ellis EF, Police RJ, Dodson LY, McKinney JS, Holt SA. Effect of dietary n-3 fatty acids on cerebral microcirculation. Am J Physiol. 1992;262(5 Pt 2):H1379–86.
 
16.
Shishehbor MH, Zhang R, Medina H, Brennan ML, Brennan DM, Ellis SG, et al. Systemic elevations of free radical oxidation products of arachidonic acid are associated with angiographic evidence of coronary artery disease. Free Radic Biol Med. 2006;41(11):1678–83.
 
17.
Sinzinger H, Kaliman J, Oguogho A. Eicosanoid production and lymphatic responsiveness in human cigarette smokers compared with non-smokers. Lymphology. 2000;33(1):24–31.
 
18.
Pawlosky RJ, Hibbeln JR, Salem Jr N. Compartmental analyses of plasma n-3 essential fatty acids among male and female smokers and nonsmokers. J Lipid Res. 2007;48(4):935–43.
 
19.
Simon JA, Fong J, Bernert Jr JT, Browner WS. Relation of smoking and alcohol consumption to serum fatty acids. Am J Epidemiol. 1996;144(4):325–34.
 
20.
Saravanan P, Davidson NC, Schmidt EB, Calder PC. Cardiovascular effects of marine omega-3 fatty acids. Lancet. 2010;376(9740):540–50.
 
21.
Nozue T, Yamamoto S, Tohyama S, Fukui K, Umezawa S, Onishi Y, et al. Effects of serum n-3 to n-6 polyunsaturated fatty acids ratios on coronary atherosclerosis in statin-treated patients with coronary artery disease. Am J Cardiol. 2013;111(1):6–11.
 
 
CITATIONS (1):
1.
The eicosapentaenoic acid:arachidonic acid ratio and its clinical utility in cardiovascular disease
J. Nelson, S. Raskin
Postgraduate Medicine
 
eISSN:1617-9625