Endocrine Abstracts

Aim: The ankle-brachial index (ABI) shows the existence of peripheral arterial disease and is also related to cardiovascular mortality in diabetic patients, even in those with coronary artery disease at an early stage. Normal levels are considered to be an ABI of 0.9 – 1.3; ABI thresholds of less than 0.9 and more than 1.3 are highly suspicious for PAD and high CV risk in diabetic patients. In this study, we planned to investigate the ankle-brachial index values in diabetic patients with and without claudication.

Materials and methods: Hundred patients were enrolled in this study. 16 patients with coronary artery disease or cerebrovascular disease were excluded. All of 84 patients were underwent ankle-brachial index (ABI) measurements in the out-patient department of internal medicine.

Results: Forty-four patients with claudication and 40 patients without claudication were included in the study. We couldn’t palpate tibial artery in three patients and dorsal artery in three patients. These six patients were reffered cardiovascular surgery due to complete obstruction. There was no significant difference between age, a1c, body mass index (BMI), waist circumference, duration of diabetes mellitus (DM) of these two groups. The right ABI was found to be higher in patients with claudiation (1.18±0.19) than patients without claudication (1.06±0.18) (P=0.003). Also the left ABI was found to be higher in patients with claudiation (1.11±0.2) than patients without claudication (1.05±0.18) (p: 0.012) (table 1). However, patients with normal and abnormal ABI levels (0.9-1.3) were not found to be related to claudication complaint. Cigarette, family history, antihypertensive drug, statin, metformin, sulfonylurea, dpp4, glitazone or insulin use were not found to be related with claudication complaint. There was a significant relationship between neuropathy (P=0.023), sex (P=0.039) and claudication complaint. In the analysis of correlation, left and right ABI measurements were not found to be correlated with age, a1c, BMI, duration of DM.

Conclusion: Early diagnosis of PAD in diabetic patients without coronary artery disease or cerebrovascular disease can be done with ABI measurments. It is especially important to take ABI measurement in our everyday practice for diabetic patients with neuropathy and claudication complaint before yet developed macrovascular complications.