Endocrinol Metab > Volume 21(5); 2006 > Article
Journal of Korean Endocrine Society 2006;21(5):382-388.
DOI: https://doi.org/10.3803/jkes.2006.21.5.382    Published online October 1, 2006.
Relationship between Diabetic Peripheral Vascular Disease and Ankle-Brachial Index.
Bo Ram Koh, Yun Kyung Kim, Sang Mi Ahn, Kyoung Eun Song, Sun Hye Jung, Hae Jin Kim, Dae Jung Kim, Yoon Sok Chung, Kwan Woo Lee
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Korea.
Abstract
BACKGROUND
Peripheral vascular disease (PVD) is a primary risk factor of foot amputation. In patients with diabetes mellitus (DM), the frequency of PVD is twice that of the general population. The ankle-brachial index (ABI) is a valuable diagnostic test for PVD. In this study, we investigated the relationship between the ABI and PVD, as well as the cutoff value of ABI in the diagnosis of PVD, and analyzed whether the ABI can be used as a predictor for amputation. METHODS: Fifty-two type 2 DM patients (31 males, 21 females) underwent peripheral angiography. PVD was defined as the complete obstruction of arteries and/or significant luminal narrowing, with collateral vessels formation, using peripheral angiography. The ABI was calculated by measurement of the segmental pressure using the Doppler method. RESULTS: Significant differences were observed between PVD and non-PVD patients in terms of age, systolic pressure and total cholesterol (each P < 0.05). The ABI was significantly lower in legs with PVD (P < 0.01) and an ABI less than 0.90 was adequate for diagnosing PVD. The risk of amputation was significantly increased in relation to the ABI level, and the risk of amputation was 21.5 times greater in a leg with an ABI less than 0.40 compared to 0.90 (P = 0.021). CONCLUSION: ABI is a good diagnostic test for PVD and a good predictor of the need for amputation.
Key Words: Ankle-brachial index, Leg amputation, Peripheral angiography, Peripheral vascular disease


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