SERUM SIALIC-ACID AND ANKLE VERSUS BRACHIAL ARTERIAL-PRESSURE RATIO IN NIDDM

Serum sialic acid is related to mortality from cardiovascular disease and is increased in patients with diabetic microangiopathies. The purp ose of this study was to examine whether serum sialic acid is associat ed with ischemic disease of the lower extremities, using the ankle ver sus brachial arterial-pressure ratio. The subjects were NIDDM patients attending diabetic clinics. They received a questionnaire on smoking and duration of diabetes, and physical examinations including measurem ent of blood pressure of upper and lower extremities. Fasting blood wa s taken for measurement of sialic acid, total and HDL cholesterol, and HbA(1c). Serum sialic acid was significantly correlated with ankle ve rsus brachial arterial-pressure ratio (r = -0.32) and HbA(1c) (r = 0.4 5). The correlation with ankle versus brachial arterial-pressure ratio was evident in the patients with low ankle versus brachial arterial-p ressure ratios (r = -0.66), but was not significant in those with norm al ankle versus brachial arterial-pressure ratios (r = 0.16). The corr elation with HbA(1c) was significant independently of ankle versus bra chial arterial-pressure ratios. Mean serum sialic acid was higher in p atients with very low ankle versus brachial arterial-pressure ratios ( <0.9) than in those with normal ankle versus brachial arterial-pressur e ratios (greater than or equal to 1.0) or slightly low ankle versus b rachial arterial-pressure ratios (0.9 similar to 1.0). These results s uggest that serum sialic acid reflects the status of blood glucose con trol and the progression of ischemic disease of the lower extremities in NIDDM patients.