Correlation of Ankle Brachial Index with Peripheral Vascular Disease in Type 2 Diabetes Mellitus

Saeed Razaq ,Khudija Nayab ,Mahrukh Fatima

doi:10.7176/jmpb/57-02

Abstract

Objective : The aim of this study was to correlate ankle brachial index (ABI) with peripheral vascular disease (PVD) in type 2 diabetes mellitus . Material and methods : This was a hospital based interdisciplinary prospective study. A total of 100 patients in the age group of 30 to 80 years having peripheral vascular disease with predefined inclusion criteria were included in the study. Patients with other causes of raised blood sugar or peripheral vascular disease were excluded by relevant investigations. Ankle Brachial Index (ABI) was calculated using sphygmomanometer, and Colour Doppler Ultrasound (CDU) was used to diagnose PVD. Both the ABI method and the CDU method were compared for detecting PVD. Results : In our study, mean age was 60.04 ± 5.03 years, mean body mass index was 27.10 ± 2.67 kg/m2 and mean duration of diabetes was 7.75 ± 1.50 years. Among the 68 diagnosed cases of PVD on CDU, 70.6% cases were detected to have PVD by the ABI method (true positive) whereas 20 (29.4%) cases remained undiagnosed when ABI alone was used for the diagnosis (false negative). Conversely, among 51 diagnosed cases of PVD by ABI method 5.9% cases were found to be normal on CDU (false positive). The ABI method was found to have specificity of 88.5% but the sensitivity was only 70.6%. Conclusion: ABI has a very high specificity but the sensitivity is low compared to colour Doppler ultrasound. Therefore, if ABI is abnormal, the diagnosis of PVD is almost certain but in symptomatic cases with normal ABI; colour Doppler should be performed to exclude the PVD. Keywords : Ankle Brachial Index, peripheral vascular disease, Colour Doppler Ultrasound, type 2 diabetes mellitus. DOI : 10.7176/JMPB/57-02 Publication date : July 31 st 2019

Highlights

Diabetes, and its complications, have become an epidemic that has become an important and challenging health problem
6 subjects were found to have calcification of peripheral vessels detected by colour Doppler ultrasound (CDU) and they were not included while calculating for sensitivity and specificity of anklebrachial index (ABI)
Out of the remaining 94 cases, 68 were diagnosed to have peripheral vascular disease (PVD) on Colour Doppler Ultrasound (CDU) and 51 cases were detected by ABI method

Summary

Introduction

Its complications, have become an epidemic that has become an important and challenging health problem. Diagnosis of PVD among diabetic patients has its limitation due to diminished clinical manifestations of the disease and diagnostic methods. ABI is a reproducible and reasonably accurate, non invasive measure for the detection of PVD and the determination of disease severity[7 ].

Results

Conclusion