The value of ankle-branchial index screening for cardiovascular disease in type 2 diabetes

Lei Xu; Rui He; Xiaohan Hua; Jun Zhao; Jungong Zhao; Hui Zeng; Lianxi Li; Fang Liu; Weiping Jia

doi:10.1002/dmrr.3076

The value of ankle-branchial index screening for cardiovascular disease in type 2 diabetes

Diabetes Metab Res Rev. 2019 Jan;35(1):e3076. doi: 10.1002/dmrr.3076. Epub 2018 Oct 25.

Authors

Lei Xu¹, Rui He¹, Xiaohan Hua¹, Jun Zhao¹, Jungong Zhao¹, Hui Zeng¹, Lianxi Li¹, Fang Liu¹, Weiping Jia¹

Affiliation

¹ Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Centre of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai, China.

PMID: 30253450
DOI: 10.1002/dmrr.3076

Abstract

Objective: To investigate the relationship between ankle-branchial index (ABI) and cardiovascular disease in type 2 diabetes patients.

Methods: A total of 634 inpatients with type 2 diabetes were recruited in this cross-sectional study. All patients were measured with ABI and computed tomography angiography (CTA) scan for coronary artery disease (CAD). According to ABI values, patients were divided into three groups: low-ABI group (ABI < 0.9, n = 259), normal-ABI group (ABI = 0.9-1.3, n = 272), and high-ABI group (ABI > 1.3, n = 103). According to the manifestation of coronary CTA, the patients were divided into CAD group (n = 348) and non-CAD group (n = 286). Their clinical data and biochemical parameters were compared and analysed.

Results: The prevalence of CAD in low-ABI group (90%) was significantly higher than that of normal-ABI group (33%) and high-ABI group (25%) (both P < 0.01). Spearman correlation analysis showed that age, sex, duration, spontaneous bacterial peritonitis, total cholesterol (TC), triglyceride, low-density lipoprotein cholesterol (LDL-C), serum creatinine, and glycosylated haemoglobin (HbA_1c ) were positively correlated with CAD, and high-density lipoprotein cholesterol (HDL-C), glomerular filtration rate, and ABI were negatively correlated with CAD. Logistic regression analysis further revealed that age, sex, duration, TC, HDL-C, LDL-C, HbA_1c , and ABI were independent risk factors of CAD. After all potential confounders is adjusted, the risk of CAD in low-ABI group still increased over four times than the normal-ABI group (odds ratio [OR], 5.32; 95% CI, 1.973-16.5; P < 0.001). In female patients, this risk increased more than nine times (OR, 10.63; 95% CI, 3.416-17.8; P < 0.001). Receiver-operating characteristic analysis indicated that ABI < 1.045 predicted the occurrence of CAD (sensitivity, 79.7%; specificity, 71.5%; P < 0.01).

Conclusions: ABI is an independent risk factor for CAD and may be a potential simple screening instrument for CAD in Chinese type 2 diabetic patients, especially in elder women.

Keywords: ankle-branchial index (ABI); coronary arterial atherosclerosis disease; peripheral atherosclerosis artery disease; type 2 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Ankle Brachial Index
Cardiovascular Diseases / diagnosis*
Cardiovascular Diseases / diagnostic imaging
Cardiovascular Diseases / etiology
Cardiovascular Diseases / physiopathology
Computed Tomography Angiography
Coronary Artery Disease / diagnosis*
Coronary Artery Disease / diagnostic imaging
Coronary Artery Disease / physiopathology
Cross-Sectional Studies
Diabetes Mellitus, Type 2 / complications*
Diabetes Mellitus, Type 2 / diagnostic imaging
Diabetes Mellitus, Type 2 / physiopathology
Diabetic Cardiomyopathies / diagnosis*
Diabetic Cardiomyopathies / diagnostic imaging
Diabetic Cardiomyopathies / physiopathology
Female
Humans
Male
Middle Aged
Sensitivity and Specificity