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Rivista di Angiologia
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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International Angiology 2012 April;31(2):134-41
Ankle-brachial index in a type 2 diabetic population with proliferative retinopathy: associated risk factors and complications
Magri C. J. 1, 2, Calleja N. 3, Buhagiar G. 4, Fava S. 2,5, Vassallo J. 2, 5 ✉
1 Department of Cardiac Services, Mater Dei Hospital, Tal-Qroqq, Msida, Malta;
2 Department of Medicine, University of Malta Medical School, Tal-Qroqq, Malta;
3 Department of Health Information & Research, G’Mangia, Malta;
4 Department of Pathology, Mater Dei Hospital, Tal-Qroqq, Msida, Malta;
5 Diabetes and Endocrine Center, Department of Medicine, Mater Dei Hospital, Tal Qroqq, Msida, Malta
AIM: The aim of this study was to analyse risk factors and complications associated with low ankle-brachial index (ABI) in a type 2 diabetic population with proliferative retinopathy.
METHODS:This study included 181 subjects. ABI was measured with a Doppler device. Subjects with ABI <0.9 were diagnosed with peripheral vascular disease (PVD). The exclusion criterion was medial arterial calcification.
RESULS: The mean (± SD) age and diabetes (DM) duration were 65±9.7 years and 18.6±9.1 years, respectively. ABI <0.9 was associated with increasing age (P<0.001), DM duration (P=0.02), higher total (P=0.02) and LDL cholesterol (P=0.035), higher ESR (P=0.04), uric acid (P=0.004) vibration perception thresholds (VPT), and lower eGFR (P<0.001). BMI (P<0.001), waist index (P=0.01), FPG (P=0.013), HbA1c (P=0.005) and ALT (P<0.001) were significantly lower in patients with PVD. Multivariate analysis revealed age (P=0.04), high total cholesterol (P=0.038), low BMI (P=0.017), low VPT (P=0 031) and declining eGFR (p=0.006) to be independent predictors of PVD.
CONCLUSION: Increasing age, total cholesterol levels, and VPT, together with declining renal function and lower BMI are independent predictors of PVD in a type 2 diabetic population with advanced microvascular disease. Knowledge of risk factors will help target preventive measures and treatment to subjects most susceptible to PVD.