The ankle-brachial index and its association with diabetic foot in type 2 diabetic outpatients with positive lower extremity symptoms

Objective To screen the prevalence of lower extremity artery disease (LEAD) in diabetic outpatients through examining the ankle-brachial index(ABI), and investigate its relationship with diabetic foot. Methods ABI was determined by Nicolet ultrasonography and quantitative sensation tester in 1010 type 2 diabetic outpatients with positive symptom of lower extremity, and clinical characterristics such as BMI, plasma glucose, HbA1c, glycolated albumin(GA) and blood pressure were collected. Patients were divided into five groups based on ABI, ABI >1.3 as group A(n=35), 0.91-1.3 as group B(n=708), 0.71-0.9 as group C(n=118), 0.41-0.7 as group D(n=115), and ≤0.4 as group E(n=34), their clinical features were compared, and the correlation and Logistic regression analysis of ABI were performed. Results Total ABI of these 1010 diabetics were 0.95±0.23(0.01-2.08), and the prevalence of LEAD was 26.44%(267/1010) diagnosed by ABI 1.3. Eighty three cases (8.02%) were diagnosed as foot disease including 50 cases of ulcer(4.95%), 13 cases of gangrene (1.29%), 20 cases of infection(1.98%). The correlation analysis inolicated that ABI was associated negatively with age, SBP, duration, HbA1c and GA, and the r value was -0.201, -0.113, -0.171, -0.160, -0.137, respectively. The Logistic regression analysis revealed that ABI was independent risk factors of foot problem (t=6.805, P=0.00). Conclusions The prevalence of lower extremity artery disease and diabetic foot is 26.4% and 8.02% in type 2 diabetes outpatients with symptoms, respectively. Age, diabetic duration, and glucose control are key risk factors of ABI. The reduction of ABI is associated nearly with the onset of diabetic foot.