title: Low estimated glomerular filtration rate is a major determinant of low ankle-brachial index and toe-brachial index in type 2 diabetes.
abstract: We enrolled 1461 Taiwanese type 2 diabetic outpatients with ankle-brachial index (ABI) and toe-brachial index (TBI) examinations, excluding participants with history of stroke, end-stage renal disease, malignancy, acute myocardial infarction, amputation, and overt calcification of the lower limbs (ABI > 1.3). Ankle-brachial index values <0.9 were found in 2.8% of the patients and 5.7% had TBI < 0.6. Estimated glomerular filtration rate (eGFR; 90 ± 33 mL/min per 1.73 m2) obtained from 473 patients correlated significantly with both ABI and TBI. Progressive eGFR decline was observed in 419 participants with normal ABI and TBI, 35 with normal ABI but low TBI, and 19 with low ABI and normal or low TBI (P for trend < .001). After adjusting for confounding factors, age and eGFR were significantly associated with TBI and ABI. Low eGFR is associated with peripheral arterial disease in type 2 diabetes with mild to moderate renal insufficiency.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital Department of Health, Executive Yuan, Taichung, Taiwan, Republic of China.
authors.forename: Yi-Jing
authors.initials: YJ
authors.lastname: Sheen
authors.forename: Jainn-Liang
authors.initials: JL
authors.lastname: Lin
authors.forename: I-Te
authors.initials: IT
authors.lastname: Lee
authors.forename: Yuan-Nian
authors.initials: YN
authors.lastname: Hsu
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
authors.forename: Wayne Huey-Herng
authors.initials: WH
authors.lastname: Sheu
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology; D012307:Risk Factors; D013624:Taiwan; D014034:Toes