Scandinavian Journal of Clinical and Laboratory Investigation | 2021
Subclinical atherosclerosis in the carotid artery: can the ankle-brachial index predict it in type 2 diabetes patients?
Abstract
Abstract Atherosclerosis is a progressive asymmetrical systemic disease that progresses faster in patients with diabetes comorbidity. Therefore, type 2 diabetic (T2DM) patients who have a high risk of, or have already detected, early atherosclerosis should be treated aggressively to prevent premature mortality. We hypothesised that subclinical atherosclerosis is predictable with the ankle-brachial index (ABI). There are currently only a few studies to indicate which specific value of ABI can predict atherosclerosis in the carotid artery. Our study aimed to examine ABI ≤ 1.1 ability to predict ultrasound-visualised atherosclerosis in carotid arteries in patients with T2DM, who had not been previously diagnosed with atherosclerosis. A population-based cross-sectional multicentric study was performed in 216 participants (mean age 59\u2009±\u20098\u2009years). Carotid artery intima-medial thickness (IMT) ≥1\u2009mm\u2009±\u2009plaque was defined as a marker for subclinical atherosclerosis and was compared with ABI. Mean duration of T2DM was 7.05\u2009±\u20096.0\u2009years. Atherosclerosis in the carotid artery was found in 96 (44%) patients, with no significant differences between genders (47 vs 53%, p = .206). ABI ≤1.1 was associated with the carotid artery mean IMT ≥1\u2009mm (p = .037), plaque (p = .027) and IMT ≥1\u2009mm\u2009±\u2009plaque (p = .037). The association between ABI ≤ 1.1 and IMT ≥ 1\u2009mm\u2009±\u2009plaque remained significant after adjustment for risk factors and age >50\u2009years. Observations demonstrated that ABI ≤ 1.1 could be an indicator of subclinical atherosclerosis for T2DM male patients over 50\u2009years old.