Risks for peripheral artery disease and cardiovascular disease indicated by high Ankle-Brachial index in T2DM patients.

Objectives: The study aims to explore clinical features linked to prominent ankle-brachial index (ABI) in type 2 diabetes mellitus (T2DM), evaluating its diagnostic utility for peripheral arterial and cardiovascular diseases, and establishing cutoffs for risk prediction in the T2DM population. Methods: The study recruited 260 outpatients with T2DM, using random sampling at Fakir Mohan Medical College, Balasore, Odisha for over 2 years from 10th April 2021 to 10th April 2023. Ankle-brachial index (ABI) measurements were taken, and participants underwent carotid arterial ultrasonography and lower limb arterial ultrasonographic examinations to assess peripheral arterial disease (PAD) and cardiovascular disease (CVD). Logit regression and ROC analysis were employed to identify independent risk factors, evaluate ABI's diagnostic potential, and determine cutoffs for predicting CVD and PAD. Results: The study revealed a parabolic prevalence curve, demonstrating that individuals having either low ABI (= 0.9) or high ABI (> 1.3) had increased risks of cardiovascular disease (CVD). A major predisposing factor for both CVD and peripheral arterial disease in patients was the presence of ABI > 1.3, which was prevalent in 14% of the cohort. The study established ABI cutoffs of 1.43 for predicting CVD and 1.45 for PAD, exhibiting specificity rates exceeding 80%, while sensitivity varied at 37.3%. Conclusion: The study underscores the clinical significance of a U-shaped prevalence curve for ankle-brachial index, revealing that high as well as low indices are independently associated with enhanced risks of peripheral arterial disease and cardiovascular disease in individuals with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]