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Levels of ankle–brachial index and the risk of diabetes mellitus complications
- Source :
- BMJ Open Diabetes Research & Care, Vol 8, Iss 1 (2020), BMJ Open Diabetes Research & Care
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- ObjectiveWe sought to compare the association of categorized ankle–brachial index (ABI) with mortality and complications of diabetes in persons with no symptoms of peripheral arterial disease (PAD) and in primary cardiovascular disease prevention.Research design and methodsThis is a retrospective cohort study of persons with type 2 diabetes aged 35–85 years, from 2006 to 2011. Data were obtained from the Sistema d'Informació per al Desenvolupament de la Investigació en Atenció Primària (SIDIAPQ). Participants had an ABI measurement that was classified into six categories. For each category of ABI, we assessed the incidence of mortality; macrovascular complications of diabetes: acute myocardial infarction (AMI), ischemic stroke, and a composite of these two; and microvascular complications of this metabolic condition: nephropathy, retinopathy, and neuropathy. We also estimated the HRs for these outcomes by ABI category using Cox proportional hazards models.ResultsData from 34 689 persons with type 2 diabetes were included. The mean age was 66.2; 51.5% were men; and the median follow-up was 6.0 years. The outcome with the highest incidence was nephropathy, with 24.4 cases per 1000 person-years in the reference category of 1.1≤ABI≤1.3. The incidences in this category for mortality and AMI were 15.4 and 4.1, respectively. In the Cox models, low ABI was associated with increased risk and was significant from ABI lower than 0.9; below this level, the risk kept increasing steeply. High ABI (over 1.3) was also associated with significant increased risk for most outcomes.ConclusionsThe studied categories of ABI were associated with different risks of type 2 diabetes complications in persons asymptomatic for PAD, who were in primary cardiovascular prevention. These findings could be useful to optimize preventive interventions according to the ABI category in this population.
- Subjects :
- Male
Cardiovascular and Metabolic Risk
vascular complications
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Population
030209 endocrinology & metabolism
Type 2 diabetes
Asymptomatic
Diseases of the endocrine glands. Clinical endocrinology
electronic patient records
Nephropathy
Diabetes Complications
primary care
03 medical and health sciences
0302 clinical medicine
peripheral arterial disease
Risk Factors
Internal medicine
Diabetes mellitus
medicine
Humans
Ankle Brachial Index
cardiovascular diseases
030212 general & internal medicine
education
Aged
Retrospective Studies
education.field_of_study
Proportional hazards model
business.industry
Incidence (epidemiology)
Retrospective cohort study
Middle Aged
RC648-665
medicine.disease
body regions
Diabetes Mellitus, Type 2
Cardiovascular Diseases
Female
medicine.symptom
business
human activities
Subjects
Details
- ISSN :
- 20524897
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- BMJ Open Diabetes Research & Care
- Accession number :
- edsair.doi.dedup.....4e9585399d693722dae1d2996a8cdb4a