title: [Peripheral arterial disease in diabetic patients: utility of the toe-brachial index].
abstract: OBJECTIVE
  To evaluate the influence of peripheral neuropathy, autonomic neuropathy and arterial wall calcification on the concordance of ankle-brachial index (ABI) and toe-brachial index (TBI) in diabetic patients.
  
  
  METHODS
  We evaluated in 221 diabetic patients (73.8% type 2; 66.6% male) the presence of: peripheral arterial disease, peripheral neuropathy, autonomic neuropathy and arterial wall calcification.
  
  
  RESULTS
  The mean (standard deviation) difference between ABI and TBI in our population was 0.33 (0.25). Patients with arterial wall calcification had a higher mean difference between ABI and TBI than patients without arterial wall calcification -0.87 (0.39) vs 0.30 (0.21) (p < 0.005)-. Mean difference between ABI and TBI was similar for patients with and without autonomic neuropathy -0.36 (0.26) vs 0.30 (0.24) (p = 0.057)- and for patients with and without peripheral neuropathy -0.34 (0.28) vs 0.31 (0.21) (p = 0.423)-. Among all patients there was a significant linear association (r = 0.506; p < 0.001) between ABI and TBI. For patients with arterial wall calcification there was no correlation between both indices (r = -0.070; p = 0,857).
  
  
  CONCLUSIONS
  Our findings indicate that in diabetic patients, TBI is the method of choice to evaluate lower limb perfusion in the presence of overt arterial wall calcification.
authors.affiliation: Unidad de Diabetes, Hospital Universitario La Paz, Madrid, España. virmarbor@hotmail.com
authors.forename: Virginia
authors.initials: V
authors.lastname: Martín Borge
authors.forename: Lucrecia
authors.initials: L
authors.lastname: Herranz de la Morena
authors.forename: Inés
authors.initials: I
authors.lastname: Castro Dufourny
authors.forename: Luis Felipe
authors.initials: LF
authors.lastname: Pallardo Sánchez
mesh_terms: D001132:Arm; D001795:Blood Pressure Determination / Q000379:methods*; D002114:Calcinosis / Q000175:diagnosis* / Q000209:etiology; D003925:Diabetic Angiopathies / Q000150:complications / Q000175:diagnosis*; D003929:Diabetic Neuropathies / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000209:etiology; D014034:Toes