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International Journal of Vascular Medicine
Volume 2017, Article ID 2390174, 7 pages
Research Article

Circulating Angiogenic Growth Factors in Diabetes Patients with Peripheral Arterial Disease and Exertional Leg Pain in Ghana

1Department of Physiology, School of Biomedical & Allied Health Sciences, University of Ghana, Accra, Ghana
2Department of Medical Laboratory Sciences, School of Biomedical & Allied Health Sciences, University of Ghana, Accra, Ghana
3Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
4Department of Chemical Pathology, School of Biomedical & Allied Health Sciences, University of Ghana, Accra, Ghana
5Department of Medicine & Therapeutics, School of Medicine & Dentistry, University of Ghana, Accra, Ghana

Correspondence should be addressed to Kwame Yeboah; moc.liamg@yknivlem

Received 23 August 2017; Revised 27 November 2017; Accepted 29 November 2017; Published 27 December 2017

Academic Editor: Robert M. Schainfeld

Copyright © 2017 Kwame Yeboah et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Peripheral arterial disease (PAD) is a common complication of diabetes, associated with impairment in angiogenesis. Angiogenesis is regulated by angiogenic growth factors such as angiopoietin 1 (Ang-1), Ang-2, and vascular endothelial growth factor (VEGF). We studied the association between angiogenic growth factors versus PAD and exertional leg symptoms in diabetes patients in Ghana. Method. In this cross-sectional study, ankle-brachial index was measured with oscillometrically and exertional leg symptoms were screened with Edinburgh claudication questionnaire in 140 diabetes patients and 110 nondiabetes individuals. Circulating levels of Ang-1, Ang-2, and VEGF were measured with immunosorbent assay. Results. The prevalence of PAD and exertional leg pain was 16.8% and 24.8%, respectively. Compared to non-PAD participants, PAD patients had higher VEGF levels [85.8 (37.5–154.5) versus 57.7 (16.6–161.1) ] and lower Ang-1 levels [31.3 (24.8–42.6) versus 40.9 (28.2–62.1), ]. In multivariable logistic regression, patients with exertional leg pain had increased the odds of plasma Ang-2 levels [OR (95% CI): 2.08 (1.08–6.41), ]. Conclusion. Diabetes patients with PAD and exertional leg pain have imbalance in angiogenic growth factors, indicating impaired angiogenesis. In patients with exertional leg pains, Ang-2 may be an important biomarker.