Muscle Mitochondrial Function in Patients with Type 2 Diabetes Mellitus and Peripheral Arterial Disease: Implications in Vascular Surgery

Objectives: (1) To review the available information on mitochondrial function in type 2 diabetes mellitus (T2DM) and peripheral arterial disease (PAD) obtained by non-invasive phosphor magnetic resonance spectroscopy ((PMRS)-P-31), near-infrared spectroscopy (NIRS) in vivo and respirometry on mitochondria isolated from muscle biopsies in vitro (2) to evaluate the usefulness of such data in the diagnosis, treatment and prognosis of these patients. Design: Review. Methods: Search strategy: PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and manual literature search. Main results: Fifty-three articles were retrieved, which included (PMRS)-P-31, 15, NIRS, 11, Combined, 1 and Respirometry, 2 and background literature, 24. Conclusion: Muscle mitochondrial function is impaired in both T2DM and PAD patients, but differently. Patients suffering from both pathological conditions will display more serious impairment of the mitochondrial function. Mitochondrial function and the degree of ischaemic disease as evaluated by (PMRS)-P-31 and NIRS are well correlated. The NIRS technique appears to determine the degree of PAD better than (PMRS)-P-31. It is argued that systematic testing of mitochondrial function may be a useful prognostic tool with PAD and T2DM, but clinical studies are needed. (C) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.