Ankle Brachial Index (ABI) measurement associated with High Sensitivity-C-Reactive Protein, Insulin Resistance and Pulse Pressure Levels in Type 2 Diabetes Mellitus Patients

Abstract

Atherosclerosis is common occurrence in type 2 diabetes mellitus (T2DM) patients. Peripheral arterial disease (PAD) is a major arteries disease caused by atherosclerosis as a vascular complication of T2DM. It can be detected by using ankle brachial index (ABI) measurement. A total of 187 subjects were recruited in present study and underwent ABI measurement. Thirty one of T2DM patients were abnormal low ABI≤0.9 (as Gr-1) and 156 non-T2DM subjects were normal ABI>0.90 (as Gr-2). Comparison of clinical characteristics of these two groups, Gr-1 were significantly increased in pulse pressure (PP), dyslipidemia, insulin, insulin resistance (IR) and high sensitivity-C-reactive protein (hs-CRP) (p<0.05) than Gr-2. Multiple forward stepwise linear regression analyses of the significant variables showed that in these decreased ABI, independent predictors of decreased ABI were hs-CRP (β =-0.488, R2 = 0.238, p<0.001), PP (β = -0.320, R2 = 0.336, p<0.001), triglyceride/high density lipoprotein-cholesterol (TG/HDL-C) ratio (β =-0.279, R2 = 0.397, p<0.001), IR (β =-0.143, R2 = 0.415, p<0.001), and Age (β = -0.115, R2= 0.428, p<0.001). In conclusion, abnormal ABI≤0.9 or PAD is associated with increased PP, inflammation, IR, dyslipidemia and age. ABI measurement is a useful tool to estimate PAD and cardiovascular diseases risk marker in asymptomatic patients.