Exp Clin Endocrinol Diabetes 2019; 127(05): 326-330
DOI: 10.1055/s-0043-122491
Article
© Georg Thieme Verlag KG Stuttgart · New York

Risk factors for patients with diabetes who have abnormal toe-brachial index and normal ankle-brachial index

Hidetaka Hamasaki
1   Hamasaki Clinic, Kagoshima, Japan
,
Yasuteru Hamasaki
1   Hamasaki Clinic, Kagoshima, Japan
› Author Affiliations
Further Information

Publication History

received 04 September 2017
revised 27 October 2017

accepted 07 November 2017

Publication Date:
02 February 2018 (online)

Abstract

Aim To investigate the association of ankle-brachial index (ABI) and toe-brachial index (TBI) with metabolic parameters and the risk factors causing a divergence between ABI and TBI in patients with diabetes.

Methods Outpatients who were simultaneously examined for both ABI and TBI were included. Multiple regression analysis was performed to assess the association of ABI and TBI with metabolic parameters. Furthermore, logistic regression analysis was performed to detect the risk factors causing a divergence between ABI and TBI.

Results Of the 307 patients that were enrolled, 77 had normal ABI but decreased TBI. ABI was inversely associated with plasma glucose and triglycerides and positively associated with high-density lipoprotein cholesterol. In contrast, TBI was inversely associated with the duration of diabetes, plasma glucose and haemoglobin A1c. Logistic regression analysis showed that smoking history and a history of cardiovascular disease were associated with an increased risk of the divergence between ABI and TBI.

Conclusion Our findings suggest that smoking history and a history of cardiovascular disease are important risk factors in patients with diabetes who had normal ABI but decreased TBI. Patients with multiple vascular complications are at a high risk of coexisting peripheral artery disease, even if their ABI is normal.

 
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