Abstract
To investigate the relationship between ankle-branchial index (ABI) and cardiovascular disease in type 2 diabetes patients. 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. 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 (HbA1c ) 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, HbA1c , 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). 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.
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