Relationships between Chronic Comorbidities and the Atherosclerosis Indicators Ankle-Brachial Index and Brachial-Ankle Pulse Wave Velocity in Patients with Type 2 Diabetes Mellitus

Abstract

This study aimed to determine associations between ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) with different comorbidities in patients with type 2 diabetes mellitus (DM). Records of patients with type 2 DM who received an ABI and baPWV examination between August 2013 and February 2015 were retrospectively reviewed. Associations of ABI and baPWV with chronic kidney disease (CKD), chronic liver disease (CLD), coronary artery disease (CAD) and diabetic nephropathy (DN) were examined by regression analysis. A total of 1232 patients (average age, 65.1±10.0 years) were included in the analysis. CKD and DN were associated with low ABI and increased baPWV (all, P<0.001). No associations were found between CAD and CLD and ABI or baPWV. Thus, regression analysis was performed for CKD and DN. Low ABI was associated with risk of CKD in the crude model (OR 0.724, 95% CI 0.648 to 0.808, P<0.001) and adjusted model (OR 0.872, 95% CI 0.762 to 0.999, P=0.048), whereas baPWV was only significant in the crude model (OR 1.199, 95% CI 1.112 to 1.294, P<0.001). Low ABI was associated with risk of DN in the crude model (OR 0.873, 95% CI 0.780 to 0.977, P=0.018) and adjusted model (OR 0.884, 95% CI 0.782 to 0.999, P=0.048). No association was found for baPWV. In conclusion, low ABI was associated with risk of CKD and DN in patients with type 2 diabetes.

Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population

“…To the best of our knowledge, this is the first study that evaluated the association between DKD and ABI in Caucasian patients with T2DM. A study in Japanese patients showed no correlation between ABI and eGFR [ 39 ], whereas a report from Taiwan revealed an independent association between ABI and DKD [ 40 ]. Given these limited data, particularly in non-Asians, and that ABI is an inexpensive, non-invasive, easily performed and sensitive marker of cardiovascular risk [ 10 , 14 ], more studies are needed to characterize the usefulness of ABI as a risk stratification tool in patients with DKD.…”

Integrated approach of brachial-ankle pulse wave velocity and cardiovascular risk scores for predicting the risk of cardiovascular events

“…As PWV is a measure of the time it takes the pulse to travel between the 2 arterial points, it is a direct measure of arterial stiffness. PWV is proportional to the speed of pulse wave through the arterial walls: when the blood vessels are young and elastic, the speed of the pulse wave traveling along the arterial wall is low; otherwise, in stiffened artery, the PWV is high [ 22 ]. Although carotid-femoral pulse wave velocity(cfPWV) is considered a gold standard non-invasive measure of arteria stiffness and has abundant clinical data [ 16 , 32 ], it has several shortcomings such as technical difficulty and inconvenience to the patients during the exam [ 16 ].…”

“…Previously, our study group reported significant correlations between baPWV and several cardiovascular risk scores including 2013 ACC/AHA ASCVD risk score [ 22 ]. The aim of this study is to compare prognostic value between baPWV and 2013 ACC/AHA ASCVD risk score, and to determine whether baPWV has incremental value to 2013 ACC/AHA ASCVD risk score in predicting future cardiovascular events.…”

Karakteristik Klinis dan Skor Ankle Brachial Index (ABI) Pada Lansia di Panti Sosial Tresna Werdha Budi Mulia 3 Jakarta Selatan

“…Berdasarkan riwayat komorbid pada penelitian ini sebagian besar responden tidak memiliki riwayat penyakit komorbid yaitu sebanyak 37 orang (61,7%). Studi yang dilakukan oleh Lee et al (2018) menunjukkan bahwa ABI merupakan data penunjang utama untuk diagnosis PAP memiliki asosiasi dengan insiden penyakit kronis meliputi diabetes mellitus, penyakit kardiovaskular (hipertensi, hiperkolesterolemia, dan merokok). Hasil analisis regresi pada studi Lee et al (2018) menunjukkan bahwa nilai rata-rata skor ABI pada pasien dengan komorbid mengalami penurunan dibandingkan nilai normal (10).…”