The Diagnostic Value Of Ankle-brachial Index,Toe-brachial Index And Brachial-ankle Pulse Wave Velocity For Peripheral Arterial Disease In Type 2 Diabetes Mellitus

Objective:To explore the correlation between brachial-ankle pulse wave velocity?ba PWV?,ankle-brachial index?ABI?,toe-brachial index?TBI?and lower limbs arterial disease in elder patients with type 2 diabetes mellitus?T2DM?,providing clinical evidence for early prevention of peripheral arterial disease.Methods:A total of 201 elder patients with type 2 diabetes mellitus?T2DM? from outpatient of endocrinology department in the Second Affiliated Hospital of D alian Medical University were enrolled in this study.According to the ultrasound results,the patients were divided into PAD group?n=98?including 58 males and 40females,average age?65.86±8.45?years old and non-PAD group?n=103?including 62males and 41 females,average age?63.12±7.64?years old.Additional 100 subjects without T2DM from the same period were enrolled as the control group,including 56males and 44 females average age?61.82±10.71?years old.The clinical data,comprising the age,gender,smoking history,blood pressure,fasting blood-glucose?FBG?,glycosylated hemoglobin?HbA₁c?,total lipids including total cholesterol?TC?and triglyceride?TG?high density lipoprotein cholesterol?HDL-C?and low density lipoprotein cholesterin?LDL-C?was collected for further analysis.The body mass index?BMI?was calculated according to the equation.ABI,TBI,and ba PWV were measured for all patients.The arterial vascular ultrasound of the lower extremities was considered as the gold standard.The sensitivity and specificity of ABI and TBI were evaluated in the elderly with T2DM combined with lower extremity arterial disease.The correlation between ABI and the arterial stenosis of lower extremities was analyzed.Finally,the diagnostic value of ABI,TBI and ba PWV in the arterial lesions of lower extremities of T2DM was evaluated.Results:1.There were significant differences in SBP,DBP,FBG,Hb A1c,TG and LDL-C in PAD group compared with non-PAD group?P<0.05?.2.Compared with the control group,the ABI and TBI in the PAD group and the non-PAD group showed a decreasing trend,and the ba PWV showed a trend of increase?P<0.05?.The ABI and TBI in the PAD group were lower than those in the non-PAD group?P<0.05?.3.Ultrasound of lower extremity was considered as the gold standard.The sensitivity of ABI in the diagnosis of PAD was 79.59%and the specificity was94.58%.When considering the ABI?0.9 as the gold standard for the diagnosis of PAD,the sensitivity of TBI was 83.14%and the specificity was 86.79%.The diagnostic value of ABI was consistent with TBI.4.The degree of arterial stenosis of lower extremity was negatively correlated with ABI?r=-0.64?,?P<0.01?.Conclusions:1.ABI,TBI and baPWV are of great predictive value in diagnosing T2DM with lower extremity arterial disease in patients.2.The ABI was negatively correlated to the degree of arterial stenosis of lower extremity,indicating that ABI could be used as an indicator of predicting the degree of stenosis of lower extremity vessels.