Open AccessToe-brachial index is beyond a peripheral issue in patients with type 2 diabetes
Author(s) -
Gisoo Darban Hosseini Amirkhiz,
Mohammad Reza Babaei,
Nahid Hashemi Madani,
Mohammad E. Khamseh
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0253138
Subject(s) - medicine , odds ratio , cardiology , confidence interval , type 2 diabetes , diabetes mellitus , peripheral , body mass index , subclinical infection , logistic regression , intima media thickness , brachial artery , blood pressure , carotid arteries , endocrinology
Background Atherosclerosis is the leading cause of death in patients with diabetes. We aimed to evaluate the association between ankle-brachial index (ABI) and toe-brachial index (TBI) with carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM). Methods This cross sectional study included 296 patients with T2DM who met the American Diabetes Association criteria for the assessment of peripheral arterial atherosclerosis. The ABI ≤ 0.9 and TBI ≤ 0.7 were considered as abnormal values. Linear and logistic regression analyses were performed to evaluate the association between TBI/ABI and CIMT. Results Right CIMT was significantly greater in the low TBI group ( p = 0.03) while, left CIMT did not show a significant difference. Each 0.1-unit decrease in TBI value was independently associated with 0.017 mm increase in the right CIMT (β ± SE; -0.017 ± 0.005, p = 0.002) and with odds of the presence of increased CIMT [odds ratio and 95% confidence interval: 1.21 (1.02, 1.44)] after adjustment with all traditional risk factors. There was not any significant association between ABI and increased CIMT. Conclusions Beyond a suitable tool for the diagnosis of peripheral artery disease in patients with T2DM, TBI can be applied for prediction of subclinical carotid atherosclerosis.