Abstract
Type 2 diabetes mellitus (DM) is an increasing global health issue. Peripheral artery occlusive disease (PAOD) is a common complication of diabetes, and it is a complex and costly disease. The association between type 2 DM and obesity is well known, however, the relationship between obesity and PAOD in patients with type 2 DM has yet to be elucidated. Therefore, the aim of this study was to examine associations between obesity-related indices and PAOD in patients with type 2 DM. A total of 1872 outpatients with type 2 DM were recruited from two hospitals in southern Taiwan. An ankle–brachial index (ABI) < 0.9 in either leg was considered to indicate the presence of PAOD. The following obesity-related indices were investigated: conicity index (CI), waist–hip ratio (WHR), body roundness index (BRI), waist-to-height ratio (WHtR), abdominal volume index, a body shape index (ABSI), visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index, body mass index and triglyceride–glucose index. Overall, 4.1% of the enrolled patients had an ABI < 0.9. High values of the following obesity-related indices were significantly associated with a low ABI: WHtR (p = 0.045), VAI (p = 0.003), CI (p = 0.042), BRI (p = 0.021) and ABSI (p = 0.043). Furthermore, WHR (area under the curve (AUC) = 0.661), CI (AUC = 0.660) and LAP (AUC = 0.642) had the best performance (all p < 0.001) to predict PAOD. In conclusion, high WHtR, BRI, CI, VAI and BAI values were associated with a low ABI in the enrolled patients, and WHR, CI and LAP were the most powerful predictors of PAOD.
Highlights
Introduction iationsType 2 diabetes mellitus (DM) is a heterogeneous abnormality characterized by insulin resistance and defective insulin secretion [1]
body adiposity index (BAI) values were associated with a low ankle–brachial index (ABI) in the enrolled patients, and waist–hip ratio (WHR), conicity index (CI) and lipid accumulation product (LAP) were the most powerful predictors of Peripheral artery occlusive disease (PAOD)
Adjusted for age, sex, total cholesterol, low-density lipoprotein cholesterol (LDL-C) and the use of medications for visceral adiposity index (VAI). The results of these analyses showed that high values of the following indices were significantly associated with a low ABI: waist-to-height ratio (WHtR), body roundness index (BRI)
Summary
Introduction iationsType 2 diabetes mellitus (DM) is a heterogeneous abnormality characterized by insulin resistance and defective insulin secretion [1]. A reported 451 million people had diabetes globally in 2017, a number which is expected to increase to 629 million by 2045. The prevalence of DM in people aged 18–99 years in 2017 was 8.4%, and this has been predicted to increase to 9.9% by 2045 [2]. In Taiwan, the age-standardized prevalence of DM in people aged 20–79 years was 6.45% in 2014 [3]. The increasing prevalence of DM and DM-related complications worldwide may increase the pressure on healthcare systems [4]. DM-associated complications include both macrovascular and microvascular diseases. The macrovascular diseases include peripheral artery occlusive disease (PAOD), cerebrovascular disease and coronary heart disease, and the microvascular diseases include neuropathy, nephropathy and retinopathy [5]. PAOD affects 9–24% of patients with DM, Licensee MDPI, Basel, Switzerland
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