Bhavika Ashok Kothari, Kallale Radhakrishnaiyengar Bhagavan, Lancelot Lobo, Nawin Kumar, Abhijit Sudhakar Shetty, Kalikivayi Babu Naresh
Department of General Surgery, K S Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India.
Background and Aim: Peripheral arterial occlusive disease (PAOD) commonly results from progressive narrowing of arteries in the lower extremities due to atherosclerosis. The objective of this study was to measure plasma levels of Lipoprotein (a) (Lp[a]) in patients with and without clinical evidence of PAOD and find an association (risk ratio) between Lp(a) and PAOD. Materials and Methods: This study was conducted in the Department of General Surgery at Justice K. S. Hegde Charitable Hospital, Mangalore. The age and sex of the patients, clinical symptoms were noted. The study included a total of 100 patients further divided into two groups: Fifty symptomatic patients with clinical evidence and 50 age and sex-matched asymptomatic patients without clinical evidence of PAOD. History of hypertension, diabetes mellitus, and ischemic heart disease were recorded. The diagnosis basically was made by clinical symptoms and signs. Arterial Doppler/computed tomography angiogram was done only if symptoms or signs of PAOD were present. Two ml of overnight fasting blood sample was collected, serum separated, and was analyzed for Lp(a) by immune turbidometry method. Results: In patients with PAOD, Lp(a) value was 90.06 ± 23.4 mg/dl, whereas among patients without PAOD, Lp(a) values was 48.02 ± 24.1 mg/dl and was statistically significant (P < 0.001). Patients with elevated Lp(a) levels were found to have 13.50 times higher risk of developing PAOD as compared to patients with normal Lp(a) levels. As per the ROC curve analysis, with area under the curve of 0.895 th cutoff value was considered to be 69.8 mg/dl with sensitivity of 88% and specificity of 76%. Conclusion: Males are at a higher risk of developing PAOD as compared to females. Patients within the age group of 51–60 years are more prone to develop PAOD as per this study. From the study results, it was found that there is a high association of patients with PAOD and elevated Lp(a) as compared to other risk factors.
Keywords: Diabetes mellitus, hypertension, lipoprotein (a), peripheral arterial occlusive disease.