title: Ankle-brachial index in a type 2 diabetic population with proliferative retinopathy: associated risk factors and complications.
abstract: OBJECTIVE
  The aim of this study was to analyse risk factors and complications associated with low ankle-brachial index (ABI) in a type 2 diabetic population with proliferative retinopathy.
  
  
  METHODS
  This study included 181 subjects. ABI was measured with a Doppler device. Subjects with ABI <0.9 were diagnosed with peripheral vascular disease (PVD). The exclusion criterion was medial arterial calcification.
  
  
  RESULTS
  The mean (± SD) age and diabetes (DM) duration were 65±9.7 years and 18.6±9.1 years, respectively. ABI <0.9 was associated with increasing age (P<0.001), DM duration (P=0.02), higher total (P=0.02) and LDL cholesterol (P=0.035), higher ESR (P=0.04), uric acid (P=0.004) vibration perception thresholds (VPT), and lower eGFR (P<0.001). BMI (P<0.001), waist index (P=0.01), FPG (P=0.013), HbA1c (P=0.005) and ALT (P<0.001) were significantly lower in patients with PVD. Multivariate analysis revealed age (P=0.04), high total cholesterol (P=0.038), low BMI (P=0.017), low VPT (P=0 031) and declining eGFR (p=0.006) to be independent predictors of PVD.
  
  
  CONCLUSIONS
  Increasing age, total cholesterol levels, and VPT, together with declining renal function and lower BMI are independent predictors of PVD in a type 2 diabetic population with advanced microvascular disease. Knowledge of risk factors will help target preventive measures and treatment to subjects most susceptible to PVD.
authors.affiliation: Department of Cardiac Services, Mater Dei Hospital, Tal-Qroqq, Msida, Malta. cjmagri013@yahoo.com
authors.forename: C J
authors.initials: CJ
authors.lastname: Magri
authors.forename: N
authors.initials: N
authors.lastname: Calleja
authors.forename: G
authors.initials: G
authors.lastname: Buhagiar
authors.forename: S
authors.initials: S
authors.lastname: Fava
authors.forename: J
authors.initials: J
authors.lastname: Vassallo
mesh_terms: D000367:Age Factors; D000368:Aged; D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008319:Malta; D008875:Middle Aged; D015999:Multivariate Analysis; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012684:Sensory Thresholds; D014732:Vibration
chemical_list: D015415:Biomarkers; D002784:Cholesterol