title: Results of blood inflammatory markers are associated more strongly with toe-brachial index than with ankle-brachial index in patients with type 2 diabetes.
abstract: OBJECTIVE
  Three blood markers of inflammation (high-sensitivity C-reactive protein [hsCRP], interleukin [IL]-6, and fibrinogen) were compared with markers of atherosclerotic cardiovascular disease (CVD) (history of stroke or cardiac ischemia and measured toe-brachial index [TBI]) to determine whether inflammatory markers are associated with atherosclerosis in patients with type 2 diabetes.
  
  
  METHODS
  Of 103 patients with type 2 diabetes, 26 had CVD. TBI was plethysmographically determined in both great toes. Serum hsCRP was immunonephelometrically determined. Plasma IL-6 was measured by an enzyme immunoassay.
  
  
  RESULTS
  Both ABI and TBI were lower in diabetic patients with CVD than in those without CVD (1.05 +/- 0.19 vs. 1.14 +/- 0.09, P < 0.05, and 0.75 +/- 0.20 vs. 0.95 +/- 0.21, P < 0.001, respectively). By linear regression, right TBI but not right ABI showed a significant negative correlation with serum hsCRP (r = -0.372, P < 0.01) and plasma fibrinogen (r = -0.224, P < 0.05). Serum hsCRP was also negatively correlated with lower TBI, but not lower ABI. We found no significant correlation between plasma IL-6 and ABI or TBI.
  
  
  CONCLUSIONS
  TBI was strongly associated with CVD, serum hsCRP, and plasma fibrinogen. Of these inflammatory markers, serum hsCRP may be the most promising marker for vascular inflammation.
authors.affiliation: Department of Internal Medicine, Dokkyo University School of Medicine, Koshigaya Hospital, Saitama, Japan. yaso@dokkyomed.ac.jp
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Aso
authors.forename: Ki-ichi
authors.initials: K
authors.lastname: Okumura
authors.forename: Teruo
authors.initials: T
authors.lastname: Inoue
authors.forename: Rika
authors.initials: R
authors.lastname: Matsutomo
authors.forename: Noboru
authors.initials: N
authors.lastname: Yoshida
authors.forename: Sadao
authors.initials: S
authors.lastname: Wakabayashi
authors.forename: Kohzo
authors.initials: K
authors.lastname: Takebayashi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Inukai
mesh_terms: D000368:Aged; D000843:Ankle Joint / Q000098:blood supply; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity / Q000502:physiology*; D001916:Brachial Artery / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D007839:Functional Laterality; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D012044:Regression Analysis; D015203:Reproducibility of Results; D014034:Toes / Q000098:blood supply
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D005340:Fibrinogen; D002097:C-Reactive Protein