Evaluation of Serum Cysteine-rich Angiogenic Inducer 61 for Peripheral Arterial Disease in Patients with Type 2 Diabetes Mellitus

Background: Peripheral artery disease (PAD) is a common manifestation of atherosclerotic disease, which is related to considerable disability and mortality. Currently, approximately 202 million people worldwide are suffering from lower extremity arterial disease, giving rise to a major public health problem and a heavy economic burden. Type 2 diabetes mellitus (T2DM) is one of the major risk factors for atherosclerosis, and the prevalence of PAD increases with the prevalence of T2DM. Materials and Methods: A cross-sectional case-control study comprising 100 cases and 40 age- and sex-matched healthy controls was done. The cases were divided into three groups: Group 1 (T2DM with PAD) - 40, Group 2 (T2DM without PAD) - 40, and Group 3 (PAD without T2DM) - 20. The serum cysteine-rich angiogenic inducer 61 (CYR61) levels were assessed using the sandwich enzyme-linked immunosorbent assay. Statistical analysis was done using MedCalc version 20.114. P <0.005 is taken as statistically significant. Results: The mean concentrations of CYR61 in Group 1, Group 2, and Group 3 were 3680 pg/ml, 3059 pg/ml, and 2866 pg/ml, respectively, whereas, in controls, it was 2318 pg/ml. The serum CYR61 levels were significantly higher in cases compared to controls (P < 0.0001). CYR61 concentrations are significantly higher in Group 1 compared to the other two groups - Group 2 and Group 3. CYR61 levels showed a statistically significant difference between Stage 2 and Stage 4 of PAD in Group 1. Receiver operating characteristic analysis has shown area under curve (0.946) for CYR61 higher than ankle-brachial index (0.750). Conclusions: CYR61 proved to be a better marker for diagnosing PAD in patients with T2DM.