The relationship between characteristics of calcinosis of the arteries of the lower extremities and the severity of distal neuropathy in the patients with diabetes mellitus

Abstract

Aim. To estimate the degree of arterial calcinosis in the distal segments of the lower extremities in the patients presenting with diabetes mellitus (DM) and varying severity of distal diabetic polyneuropathy (DPN). Materials and methods. The study involved 61 patients with DM ( 21 men and 40 women, mean age 51.4 +- 11.68 years) of whom 27 suffered DM1 and 34 DM2. Group 1 was comprised of 37 patients with diabetic osteoarthropathy (DOAP), group 2 included 13 patients with severe DPN, and group 3 11 patients having moderate DPN. All the patients underwent comprehensive laboratory and instrumental examination including measurement of peripheral sensitivity and electromyography. The degree of arterial calcinosis in the distal segments of the lower extremities was determined using multispiral computed tomography (MSCT) with the calculation of the Agatston tibial artery calcification scores. Results. The groups were matched for the patients' age, duration of disease, total cholesterol and creatinin levels, and glomerular filtration rate. Moreover, the patients of groups 1 and 2 were matched for the functional state of nerve fibers in the lower extremities and were significantly different in respect to this characteristic from the patients of group 3. Median of the Agatston tibial artery calcification scores in group 1 was 365.4 (min - 0, max - 1600) and in group 2 2.7 (min - 0, max - 74.6). Groups 1 and 2 were comparable in terms of the degree of calcinosis and were significantly different from group 3 (p < 0.05 1 vs 3; p < 0.005 2 vs 3). The Agatston tibial artery calcification scores negatively correlated with the motor response (r = -0.3; p < 0.05) and vibrational sensitivity (r = -0.4, p < 0.01). Conclusion. Results of the study suggest the leading role of DPN in the development and progression of arterial calcinosis in the distal segments of the lower extremities in the patients with diabetes mellitus.