Toe-brachial index is beyond a peripheral issue in patients with type 2 diabetes

• Published in: PloS one Vol. 16; no. 6; p. e0253138
• Main Authors: Darban Hosseini Amirkhiz, Gisoo, Babaei, Mohammad Reza, Madani, Nahid Hashemi, Khamseh, Mohammad Ebrahim
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 15.06.2021; Public Library of Science (PLoS)
• Subjects: Age; Ankle; Asymptomatic; Atherosclerosis; Biology and life sciences; Blood pressure; Body mass index; Cardiovascular disease; Cardiovascular diseases; Casualties; Cellulitis; Cholesterol; Complications and side effects; Congestive heart failure; Coronary vessels; Density; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diagnosis; Dyslipidemia; Editing; Endocrinology; Gender; Glucose; Hemoglobin; High density lipoprotein; Hypertension; Laboratories; Life expectancy; Life span; Low density lipoprotein; Lymphedema; Measurement; Medical research; Medical science; Medical treatment; Medicine and Health Sciences; Metabolism; Methodology; Patient outcomes; Patients; Peripheral vascular diseases; Radiology; Research facilities; Risk analysis; Risk factors; Smoking; Thromboembolism; Thrombophlebitis; Thrombosis; Triglycerides; Type 2 diabetes; Ultrasonic imaging; Iran
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0253138

Atherosclerosis is the leading cause of death in patients with diabetes. We aimed to evaluate the association between ankle-brachial index (ABI) and toe-brachial index (TBI) with carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM). This cross sectional study included 296 patients with T2DM who met the American Diabetes Association criteria for the assessment of peripheral arterial atherosclerosis. The ABI [less than or equal to] 0.9 and TBI [less than or equal to] 0.7 were considered as abnormal values. Linear and logistic regression analyses were performed to evaluate the association between TBI/ABI and CIMT. Right CIMT was significantly greater in the low TBI group (p = 0.03) while, left CIMT did not show a significant difference. Each 0.1-unit decrease in TBI value was independently associated with 0.017 mm increase in the right CIMT ([beta] ± SE; -0.017 ± 0.005, p = 0.002) and with odds of the presence of increased CIMT [odds ratio and 95% confidence interval: 1.21 (1.02, 1.44)] after adjustment with all traditional risk factors. There was not any significant association between ABI and increased CIMT. Beyond a suitable tool for the diagnosis of peripheral artery disease in patients with T2DM, TBI can be applied for prediction of subclinical carotid atherosclerosis.