СLINICAL AND LABORATORY CHARACTERISTICS OF LOWER EXTREMITY ARTERIAL DISEASE IN THE CONDITIONS OF COMORBIDITY
DOI:
https://doi.org/10.32782/health-2025.2.5Keywords:
atherosclerosis of the lower extremities, clinical and laboratory indicators, comorbidity, diabetes mellitus, hypertension, obesity, chronic obstructive pulmonary disease, uric acidAbstract
Comorbidity is not only a global medical issue that determines the individual prognosis for each patient but also has widespread social consequences at the population level. This is particularly important for defining diagnostic and therapeutic approaches to patient management. Lower extremity arterial disease (LEAD) represents a serious medical and social problem. In patients with hypertension, it is accompanied by more pronounced hemodynamic disturbances, lipid profile abnormalities, and vascular structural changes, necessitating a comprehensive approach to diagnosis, treatment, and risk factor control. Furthermore, it has been observed that the prevalence of LEAD increases with a more significant decline in glomerular filtration rate (GFR). Logistic regression analysis has shown that uric acid and GFR are independent risk factors for diabetic LEAD. Endothelial dysfunction in diabetic nephropathy affects not only the renal capillaries but also the vascular system as a whole. Plasma proteins can penetrate through damaged endothelial cells, triggering vascular changes and promoting the progression of atherosclerosis. Elevated TNF levels in patients with LEAD are associated with worsening tissue trophism in the lower extremities, endothelial dysfunction, and overall physical weakness, often leading to the development of cachexia. TNF, also known as «cachectin», predicts poor prognosis in systemic atherosclerosis and circulatory disorders. Thus, LEAD is a disease with a pronounced systemic inflammatory component, similar to chronic obstructive pulmonary disease, and the evaluation of pro-inflammatory markers could be used to predict disease progression, assess the risk of complications, and stratify patients by severity. Therefore, the combination of these pathologies necessitates a comprehensive approach to diagnosis, prevention, and treatment, aimed at addressing vascular, metabolic, and respiratory disorders.
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