Ankle-brachial index in a type 2 diabetic population with proliferative retinopathy: associated risk factors and complications

Int Angiol. 2012 Apr;31(2):134-41.

Abstract

Aim: The aim of this study was to analyse risk factors and complications associated with low ankle-brachial index (ABI) in a type 2 diabetic population with proliferative retinopathy.

Methods: This study included 181 subjects. ABI was measured with a Doppler device. Subjects with ABI <0.9 were diagnosed with peripheral vascular disease (PVD). The exclusion criterion was medial arterial calcification.

Results: The mean (± SD) age and diabetes (DM) duration were 65±9.7 years and 18.6±9.1 years, respectively. ABI <0.9 was associated with increasing age (P<0.001), DM duration (P=0.02), higher total (P=0.02) and LDL cholesterol (P=0.035), higher ESR (P=0.04), uric acid (P=0.004) vibration perception thresholds (VPT), and lower eGFR (P<0.001). BMI (P<0.001), waist index (P=0.01), FPG (P=0.013), HbA1c (P=0.005) and ALT (P<0.001) were significantly lower in patients with PVD. Multivariate analysis revealed age (P=0.04), high total cholesterol (P=0.038), low BMI (P=0.017), low VPT (P=0 031) and declining eGFR (p=0.006) to be independent predictors of PVD.

Conclusion: Increasing age, total cholesterol levels, and VPT, together with declining renal function and lower BMI are independent predictors of PVD in a type 2 diabetic population with advanced microvascular disease. Knowledge of risk factors will help target preventive measures and treatment to subjects most susceptible to PVD.

MeSH terms

  • Age Factors
  • Aged
  • Ankle Brachial Index*
  • Biomarkers / blood
  • Chi-Square Distribution
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Retinopathy / blood
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / etiology*
  • Diabetic Retinopathy / physiopathology
  • Female
  • Humans
  • Male
  • Malta
  • Middle Aged
  • Multivariate Analysis
  • Peripheral Vascular Diseases / blood
  • Peripheral Vascular Diseases / diagnosis
  • Peripheral Vascular Diseases / etiology*
  • Peripheral Vascular Diseases / physiopathology
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Sensory Thresholds
  • Vibration

Substances

  • Biomarkers
  • Cholesterol