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. 2021 Jun 15;16(6):e0253138.
doi: 10.1371/journal.pone.0253138. eCollection 2021.

Toe-brachial index is beyond a peripheral issue in patients with type 2 diabetes

Gisoo Darban Hosseini Amirkhiz  1 , Mohammad Reza Babaei  2 , Nahid Hashemi Madani  3 , Mohammad Ebrahim Khamseh  3
Affiliations

Toe-brachial index is beyond a peripheral issue in patients with type 2 diabetes

Gisoo Darban Hosseini Amirkhiz et al. PLoS One. .

Abstract

Background: Atherosclerosis is the leading cause of death in patients with diabetes. We aimed to evaluate the association between ankle-brachial index (ABI) and toe-brachial index (TBI) with carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM).

Methods: This cross sectional study included 296 patients with T2DM who met the American Diabetes Association criteria for the assessment of peripheral arterial atherosclerosis. The ABI ≤ 0.9 and TBI ≤ 0.7 were considered as abnormal values. Linear and logistic regression analyses were performed to evaluate the association between TBI/ABI and CIMT.

Results: Right CIMT was significantly greater in the low TBI group (p = 0.03) while, left CIMT did not show a significant difference. Each 0.1-unit decrease in TBI value was independently associated with 0.017 mm increase in the right CIMT (β ± SE; -0.017 ± 0.005, p = 0.002) and with odds of the presence of increased CIMT [odds ratio and 95% confidence interval: 1.21 (1.02, 1.44)] after adjustment with all traditional risk factors. There was not any significant association between ABI and increased CIMT.

Conclusions: Beyond a suitable tool for the diagnosis of peripheral artery disease in patients with T2DM, TBI can be applied for prediction of subclinical carotid atherosclerosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Graph illustrating correlation between right CIMT and TBI (A) and ABI (B).
CIMT: carotid intima media thickness. TBI: toe brachial index. ABI: ankle brachial index.
See this image and copyright information in PMC

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