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Resumen Fundamento y objetivo La pulsioximetria se ha propuesto como metodo de cribado de la vasculopatia periferica. Dado que la arteriosclerosis afecta a todo el territorio vascular, estudiamos su eficacia para detectar pacientes con diabetes mellitus tipo 2 (DM2) con arteriosclerosis carotidea. Pacientes y metodo Se incluyeron 105 pacientes con DM2 sin historia previa de vasculopatia periferica. Se realizo historia clinica, exploracion fisica, medicion del indice tobillo-brazo (ITB) y de la saturacion de oxigeno en el pie y la mano mediante pulsioximetria, analisis sanguineo y ecografia carotidea (medicion del grosor intima-media carotideo y de placas carotideas [PC]). Se consideraron patologicos los valores de ITB inferiores a 0,9 y un descenso en la pulsioximetria de la saturacion de oxigeno superior al 2% en los pies respecto de la mano o tras la elevacion de la extremidad inferior respecto del decubito supino. Resultados Sesenta pacientes eran varones (edad media de 62,1 anos [desviacion estandar de 7,1] y hemoglobina glucosilada media del 6,9% [1,0]). Un 58,1% presentaba PC. Los datos antropometricos y analiticos fueron homogeneos entre los pacientes con y sin PC. El ITB fue inferior a 0,9 en el 49% y en el 25% de los pacientes con y sin PC, respectivamente. No hubo diferencias en la pulsioximetria en funcion de la presencia de PC ni del ITB patologico. Tampoco el grosor intima-media fue diferente en funcion de la pulsioximetria, aunque fue mayor en los pacientes con PC y con ITB inferior a 0,9 que en aquellos sin alteraciones. Estos resultados fueron independientes de la historia de macroangiopatia clinica. Conclusiones La pulsioximetria no es util en el cribado de la aterosclerosis carotidea en pacientes con DM2.

Background and objective: To study Chlamydophila pneumoniae DNA (CP-DNA) in leukocytes measured by real-time polymerase chain reaction (PCR) in patients with type 2 diabetes mellitus (DM2) with different degrees of atherosclerosis, a cross-sectional protocol was performed. Patients and methods: We included 135 patients with DM2. Clinical, metabolic and inflammatory variables were measured. Previous clinical macrovascular disease was recorded and carotid ultrasound and real-time PCR for CP-DNA were performed. Results: Mean age was 62 (7) years and mean diabetes duration 16 (9) years; 40.7% of patients presented clinical atherosclerosis, 32.5% subclinical atherosclerosis and 26.6% no evidence of atherosclerosis. Anthropometric data were homogeneous in the three groups. Patients with clinical atherosclerosis had greater carotid intima-media thickness compared to the other two groups. No CP-DNA was detected in any patient. Conclusions: The lack of detection of CP-DNA in blood leukocytes suggests that C. pneumoniae plays no active, systemic role in the pathogenesis of atherosclerosis in DM2 patients and is not a reliable marker of atherosclerosis in high-risk patients.

Pulse oximetry of the toes has been suggested in the screening of peripheral arterial disease. We studied the uselfuness of pulse oximetry in detection of type 2 diabetic patients with carotid atherosclerosis.105 patients with type 2 diabetes mellitus (DM) without previous clinical peripheral arterial disease were enrolled. All patients had (1) ankle-brachial index (ABI) measurement, (2) pulse oximetry to measure SaO(2) of their index fingers and big toes in the supine position and at elevated 30cm and (3) a carotid ultrasound [carotid artery intima-media thickness (IMT) and carotid plaques (CP) measurements]. The ABI was considered abnormal when it was0.9 and when the pulse oximetry showed a decrease in SaO(2) of2% of the finger compared to foot or to 30cm foot elevation.60 patients were men (age of 62+/-7 years, HbA(1c) of 6.9+/-1.0); 58.1% had CP. There were no differences in anthropometric and biochemical results between patients with or without CP. The ABI was0.9 in 49% and 25% of patients with and without CP, respectively. Neither were there differences in pulse oximetry in patients with CP or in those with ABI0.9. The IMT did not change in relation to pulse oximetry, but it was higher in patients with CP and with ABI0.9 than in patients without alterations. These results were independent of the presence of previous clinical macroangiopathy.Pulse oximetry is not a useful screening method of carotid atherosclerosis in type 2 DM.