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Diverging effects of diabetes mellitus in patients with peripheral artery disease and abdominal aortic aneurysm and the role of advanced glycation end-products: ARTERY study – protocol for a multicentre cross-sectional study.

Diverging effects of diabetes mellitus in patients with peripheral artery disease and abdominal aortic aneurysm and the role of advanced glycation end-products: ARTERY study – protocol for a multicentre cross-sectional study.
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de Vos LC, Boersema J, Hillebrands JL, Schalkwijk CG, Meerwaldt R, Breek JC, Smit AJ, Zeebregts CJ, Lefrandt JD,


de Vos LC, Boersema J, Hillebrands JL, Schalkwijk CG, Meerwaldt R, Breek JC, Smit AJ, Zeebregts CJ, Lefrandt JD, (click to view)

de Vos LC, Boersema J, Hillebrands JL, Schalkwijk CG, Meerwaldt R, Breek JC, Smit AJ, Zeebregts CJ, Lefrandt JD,

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BMJ open 2017 04 117(4) e012584 doi 10.1136/bmjopen-2016-012584
Abstract
INTRODUCTION
Diabetes mellitus is a well-defined risk factor for peripheral artery disease (PAD), but protects against the development and growth of abdominal aortic aneurysm (AAA). Diabetes mellitus is associated with arterial stiffening and peripheral arterial media sclerosis. Advanced glycation end-products (AGEs) are increased in diabetes mellitus and cardiovascular disease. AGEs are known to form cross-links between proteins and are associated with arterial stiffness. Whether AGEs contribute to the protective effects of diabetes mellitus in AAA is unknown. Therefore, the ARTERY (Advanced glycation end-pRoducts in patients with peripheral arTery disEase and abdominal aoRtic aneurYsm) study is designed to evaluate the role of AGEs in the diverging effects of diabetes mellitus on AAA and PAD.

METHODS AND ANALYSIS
This cross-sectional multicentre study will compare the amount, type and location of AGEs in the arterial wall in a total of 120 patients with AAA or PAD with and without diabetes mellitus (n=30 per subgroup). Also, local and systemic vascular parameters, including pulse wave velocity, will be measured to evaluate the association between arterial stiffness and AGEs. Finally, AGEs will be measured in serum, urine, and assessed in skin with skin autofluorescence using the AGE Reader.

ETHICS AND DISSEMINATION
This study is approved by the Medical Ethics committees of University Medical Center Groningen, Martini Hospital and Medisch Spectrum Twente, the Netherlands. Study results will be disseminated through peer-reviewed journals and scientific events.

TRIAL REGISTRATION NUMBER
trialregister.nl NTR 5363.

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