J Korean Endocr Soc.  2006 Oct;21(5):382-388. 10.3803/jkes.2006.21.5.382.

Relationship between Diabetic Peripheral Vascular Disease and Ankle-Brachial Index

• Koh BR
• Kim YK
• Ahn SM
• Song KE
• Jung SH
• Kim HJ
• Kim DJ
• Chung YS
• Lee KW

• KMID: 1511987
• DOI: http://doi.org/10.3803/jkes.2006.21.5.382

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.

Keyword

Ankle-brachial index; Leg amputation; Peripheral angiography; Peripheral vascular disease

MeSH Terms

Amputation
Angiography
Ankle Brachial Index*
Arteries
Blood Pressure
Cholesterol
Diabetes Mellitus
Diagnosis
Diagnostic Tests, Routine
Foot
Humans
Leg
Male
Peripheral Vascular Diseases*
Phenobarbital
Risk Factors
Cholesterol
Phenobarbital

Figure

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  Fig. 1 Receiver-operating characteristic (ROC) curves for ankle-brachial index (ABI) for diagnosing peripheral vascular disease. The cutoff value of ABI is 0.91. The area under the ROC curve (95% CI) for the parameter is 0.758 (0.661~0.856).

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