Levels of ankle–brachial index and the risk of diabetes mellitus complications

Alves-Cabratosa, Lia; Comas-Cufí, Marc; Ponjoan, Anna; García-Gil, Maria; Martí-Lluch, Ruth; Blanch, Jordi; Elosúa-Bayes, Marc; Parramon, Dídac; Camós, Lourdes; Guzmán, Lidia; Ramos, Rafel

doi:10.1136/bmjdrc-2019-000977

Cited by 24 publications

(26 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…ROC results revealed that the combination of ABI and baPWV may improve risk classification in predicting all-cause and expanded CVD mortality in patients with T2DM. ABI and baPWV are simple, non-invasive, economical, and realistic measures that have become increasingly important in predicting mortality [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] . Most studies exploring the associations of ABI and/or baPWV with mortality in T2DM population [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] only considered ABI alone [28][29][30][31][32][33][34][35][36][37]…”

Section: Discussionmentioning

confidence: 99%

“…Only two works considered baPWV alone 43,44 , and another two simultaneously considered ABI and baPWV 45,46 . As a consequence, the findings on the association between ABI and mortality were inconsistent [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] . Significant associations were observed in some studies [28][29][30][31][32][33][34][35][36][37][38][39][40] but not in others 41,42 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prediction of all-cause and cardiovascular mortality using ankle-brachial index and brachial-ankle pulse wave velocity in patients with type 2 diabetes

Lin

Liu

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are used as non-invasive indicators for detecting atherosclerosis and arterial stiffness, two well-known predictors of mortality in patients with type 2 diabetes mellitus (T2DM). ABI and baPWV have independent associations with mortality; however, their joint and interactive effects on mortality have not been assessed in patients with T2DM. This work aims to evaluate the independent, joint, and interactive associations of ABI and baPWV with all-cause and expanded cardiovascular disease (CVD) mortality in patients with T2DM. This observational study included 2160 patients with T2DM enlisted in the Diabetes Care Management Program database of China Medical University Hospital from 2001 to 2016 and then followed their death status until August 2021. Cox proportional hazard models were used to evaluate the independent, joint, and interactive effects of ABI and baPWV on the risk of all-cause and expanded CVD mortality. A total of 474 patient deaths occurred after a mean follow-up of 8.4 years, and 268 of which were attributed to cardiovascular events. Abnormal ABI (≤ 0.9) and highest baPWV quartile were independently associated with increased risks of all-cause [ABI: hazard ratio (HR) 1.67, 95% confidence interval (CI) 1.30–2.11; baPWV: 1.63, 1.16–2.27] and expanded CVD mortality (ABI: 2.21, 1.62–3.02; baPWV: 1.75, 1.09–2.83). The combination of abnormal ABI (≤ 0.9) and highest baPWV quartile was associated with a significantly higher risk of all-cause (4.51, 2.50–8.11) and expanded CVD mortality (9.74, 4.21–22.51) compared with that of the combination of normal ABI and lowest baPWV quartile. Significant interactions were observed between ABI and baPWV in relation to all-cause and expand CVD mortality (both p for interaction < 0.001). Through their independent, joint, and interactive effects, ABI and baPWV are significant parameters that can improve the prediction of all-cause and expanded CVD mortality in patients with T2DM and help identify high-risk patients who may benefit from diabetes care.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prediction of all-cause and cardiovascular mortality using ankle-brachial index and brachial-ankle pulse wave velocity in patients with type 2 diabetes

Lin

Liu

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“… 7 Ankle brachial index (ABI) is a non-invasive tool for detecting vascular status and for measuring lower leg arteries versus upper leg arterial health status. 8 ABI is the ratio between the lower limb (ankle) systolic blood pressure and the upper limb (upper arm) systolic blood pressure. ABI reflects vascular resistance, which explains the main factors: the blood vessel diameter, which can be narrowed either from internal factors (plaque and intimal tearing) or from external factors, such as compression by soft tissue.…”

Section: Introductionmentioning

confidence: 99%

Early detection of macrovascular complications in type 2 diabetes mellitus in Medan, North Sumatera, Indonesia: A cross-sectional study

et al. 2021

View full text Add to dashboard Cite

Background: Macrovascular complications occur very frequently in patients with type 2 diabetes mellitus (T2DM) with a high mortality rate, due to the development of cardiovascular disease (CVD), such as stroke, atherosclerosis acceleration, and atrial fibrillation. T2DM is a significant risk factor for CVD and has become the leading cause of death. The purpose of this study was to detect the early risk of macrovascular complications by using the ankle brachial index (ABI) as a marker. Methods: This study was an analytic study with a cross-sectional approach. The study population was patients with T2DM from several primary health care centers in Medan. In total, 89 subjects who met the inclusion and exclusion criteria were recruited with consecutive sampling. ABI was determined as the ratio of systolic blood pressure in the brachial artery to the posterior tibial artery after the subjects had been relaxed and felt comfortable in a supine position. Examination of vitamin D and lipid profile was derived from examination of venous blood. Data were processed using SPSS and analyzed with one-way ANOVA. Results: The study found that there was a relationship between LDL-C, triglyceride, and vitamin D (25OH-D) based on the ABI (p > 0.05). Conclusions: ABI can be used for an early detection of macrovascular complications. Apart from being easy to perform, ABI was non-invasive. Some other risk factors that can also be used to assess complications and have relationships with ABI were LDL-C, triglyceride, and vitamin D (25OH-D). Complications in T2DM patients can be prevented with reasonable blood sugar control and lifestyle changes. Education and motivation need to be given to patients so that they become more independent in controlling their disease and improving their quality of life.

show abstract

“…[ 7 ] Association of different categories of ABI in a large group of type II diabetics over a period of 6 years showed a high incidence of mortality and acute myocardial infarction, suggesting the importance of preventive measures in such persons. [ 8 ] The prevalence of PAD has been recorded in various studies differently. It was relatively lower (13.7%) when only early type II diabetes patients were included who did not have any previously diagnosed complications.…”

Section: Discussionmentioning

confidence: 99%

Use of ABI to detect peripheral arterial disease in diabetes – A recommendation for primary care physicians

Mishra

2021

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

Background: India is considered the diabetes capital of the world. As per current practice, most of the diabetes patients go to primary care physicians for their monitoring and follow up. One of the dreaded complications of long-term diabetes is peripheral arterial disease. Methods: A cross-sectional observational study was conducted in a diabetes workshop. Totally, 48 patients were selected who satisfied the inclusion criteria. All were subjected to ankle-brachial index measurement (ABI) and doppler ultrasound was done to assess patency of the lower extremity arteries. The results were compared. The ankle-brachial index of less than 0.99 was considered abnormal. Results: Out of a total of 48 included patients 26 patients had normal ABI and 22 patients were found to have abnormal ABI. Out of those with normal ABI, 2 patients had features of peripheral arterial disease proved by doppler, whereas 3 patients with abnormal ABI had no feature of peripheral arterial disease in doppler. MedCalc software was used for statistical comparison. Conclusion: In the selected diabetic population prevalence of peripheral arterial disease was found to be 56.25%. Measurement of ABI was found to be quite a sensitive and specific method for diagnosing peripheral arterial disease of diabetics.

show abstract

Levels of ankle–brachial index and the risk of diabetes mellitus complications

Cited by 24 publications

References 49 publications

Prediction of all-cause and cardiovascular mortality using ankle-brachial index and brachial-ankle pulse wave velocity in patients with type 2 diabetes

Prediction of all-cause and cardiovascular mortality using ankle-brachial index and brachial-ankle pulse wave velocity in patients with type 2 diabetes

Early detection of macrovascular complications in type 2 diabetes mellitus in Medan, North Sumatera, Indonesia: A cross-sectional study

Use of ABI to detect peripheral arterial disease in diabetes – A recommendation for primary care physicians

Contact Info

Product

Resources

About