Titre du document / Document title

Lower-limb vascularization in diabetic patients assessment by thallium-201 scanning coupled with exercise myocardial scintigraphy

Auteur(s) / Author(s)

COSSON Emmanuel ⁽¹⁾ ; PAYCHA Frederic ⁽²⁾ ; TELLIER Philippe ⁽³⁾ ; SACHS Regis Nessim ⁽¹⁾ ; RAMADAN Arabi ⁽²⁾ ; PARIES Jacques ⁽¹⁾ ; ATTALI Jean-Raymond ⁽¹⁾ ; VALENSI Paul ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Endocrinology-Diabetology-Nutrition, Paris-Nord University, Jean Verdier Hospital., Bondy, FRANCE
⁽²⁾ Department of Nuclear Medicine, Louis Mourier Hospital, Colombes, FRANCE
⁽³⁾ Department of Nuclear Medicine, Clinique Sainte Catherine les Arras, Sainte Catherine les Arras, FRANCE

Résumé / Abstract

OBJECTIVE - To investigate, by thallium-201 scanning, circulation in the muscles of the lower limb (LL) in diabetic patients without clinical peripheral vascular disease but with a high cardiovascular risk profile. RESEARCH DESIGN AND METHODS - A total of 80 diabetic patients (76 patients with type 2 diabetes, mean age 57. 3 years, duration of diabetes 13.0 ± 7.5 years) with more than one additional cardiovascular risk factor but no claudication were investigated. After stress testing, 1.5 5 MBq/kg thallium-201 was administered to perform myocardial single-photon emission computed tomography followed by LL scanning Muscle blood flow was considered abnormal if the asymmetry in thallium-201 uptake between the two buttocks and/or thighs and/or calves was > 10%. RESULTS - Muscle perfusion defects were found in 42% of the patients, mainly in the calves. These defects correlated with retinopathy (P = 0.042) and the HbA_1clevel (P = 0.044). In patients with defects in the buttock and/or thigh, the prevalence of nephropathy and retinopathy was higher than in those with isolated defects in the calf (P = 0.032 and 0.023, respectively), CONCLUSIONS - This study suggests that LL scanning coupled with myocardial scintigraphy is a convenient method of investigating peripheral muscle circulation. Proximal perfusion defects in patients without clinical arterial disease are associated with increased prevalence of retinopathy and nephropathy and, therefore, may be due to microvascular disease of LL muscle. Distal defects may indicate silent macrovascular disease of the LL.

Revue / Journal Title

Diabetes care   ISSN 0149-5992   CODEN DICAD2 

Source / Source

2001, vol. 24, n^o5, pp. 870-874 (25 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Diabetes Association, Alexandria, VA, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Insulin dependent diabetes ; Non insulin dependent diabetes ; Vascularization ; Lower limb ; Muscle ; Scintigraphy ; Thallium ; Angiocardiography ; Nephropathy ; Retinopathy ; Adult ; Elderly ; Human ; Endocrinopathy ; Immunopathology ; Autoimmune disease ; Radionuclide study ; Medical imagery ; Radiodiagnosis ; Urinary system disease ; Kidney disease ; Eye disease ;

Mots-clés français / French Keywords

Diabète insulinodépendant ; Diabète non insulinodépendant ; Vascularisation ; Membre inférieur ; Muscle ; Scintigraphie ; Thallium ; Angiocardiographie ; Néphropathie ; Rétinopathie ; Adulte ; Personne âgée ; Homme ; Endocrinopathie ; Immunopathologie ; Maladie autoimmune ; Exploration radioisotopique ; Imagerie médicale ; Radiodiagnostic ; Appareil urinaire pathologie ; Rein pathologie ; Oeil pathologie ;

Mots-clés espagnols / Spanish Keywords

Diabetes insulinodependiente ; Diabetes no insulinodependiente ; Vascularización ; Miembro inferior ; Músculo ; Centelleografía ; Talio ; Angiocardiografía ; Nefropatía ; Retinopatía ; Adulto ; Anciano ; Hombre ; Endocrinopatía ; Inmunopatología ; Enfermedad autoinmune ; Exploración radioisotópica ; Imageneria medical ; Radiodiagnóstico ; Aparato urinario patología ; Riñón patología ; Ojo patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 18054, 35400009817348.0150