Better Detection of Peripheral Arterial Disease with Toe-Brachial Index Compared to Ankle-Brachial Index among Taiwanese Patients with Diabetic Kidney Disease
Background: Ankle-brachial index (ABI) is a simple method for diagnosing peripheral artery disease (PAD) but has limited reliability in patients with diabetes mellitus (DM) because of medial artery calcification. Our study aims to investigate whether the toe brachial index (TBI) or the cardio-ankle...
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| Format: | Article |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7393 |
| _version_ | 1797399964358279168 |
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| author | Chia-Wei Chang Ya-Wen Sung Yu-Ting Huang Yong-Chuan Chung Mei-Yueh Lee |
| author_facet | Chia-Wei Chang Ya-Wen Sung Yu-Ting Huang Yong-Chuan Chung Mei-Yueh Lee |
| author_sort | Chia-Wei Chang |
| collection | DOAJ |
| description | Background: Ankle-brachial index (ABI) is a simple method for diagnosing peripheral artery disease (PAD) but has limited reliability in patients with diabetes mellitus (DM) because of medial artery calcification. Our study aims to investigate whether the toe brachial index (TBI) or the cardio-ankle vascular index (CAVI) has a better detection over the ABI for diagnosing PAD in diabetic kidney disease (DKD). Materials and Methods: A cohort of 368 patients (mean age 68.59 ± 13.14 years, 190 males and 178 females) with type 2 DM underwent ABI, TBI, and CAVI measurements at our outpatient clinic. Results: Of all enrolled patients, the TBI is significant in evaluating PAD, especially in patients whose chronic kidney disease (CKD) stage 3a with adjusted odds ratio (AOR) = 6.50, 95% confidence interval (CI) 1.63–25.97, <i>p</i> = 0.0080, stage 3b AOR = 7.47, 95% CI 1.52–36.81, <i>p</i> = 0.0135, and stage 4–5 AOR = 20.13, 95% CI 1.34–94.24, <i>p</i> = 0.0116. CAVI is also significant in CKD stage 1 with AOR = 0.16, 95% CI 0.03–0.77, <i>p</i> = 0.0223, stage 2 with AOR = 0.18, 95% CI 0.04–0.74, <i>p</i> = 0.0180, and stage 3a AOR = 0.31, 95% CI 0.10–0.93, <i>p</i> = 0.0375. Conclusion: TBI has a better yield of detection of PAD compared to ABI among Taiwanese patients with DKD. CAVI may play a role in the early stage of DKD. |
| first_indexed | 2024-03-09T01:47:47Z |
| format | Article |
| id | doaj.art-44052aafb7aa4901b74f01dbfd73df18 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:47:47Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-44052aafb7aa4901b74f01dbfd73df182023-12-08T15:19:44ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223739310.3390/jcm12237393Better Detection of Peripheral Arterial Disease with Toe-Brachial Index Compared to Ankle-Brachial Index among Taiwanese Patients with Diabetic Kidney DiseaseChia-Wei Chang0Ya-Wen Sung1Yu-Ting Huang2Yong-Chuan Chung3Mei-Yueh Lee4School of Medicine, Kaohsiung Medical University, Kaohsiung 807, TaiwanDepartment of Nursing, Kaohsiung Medical University Hospital, Kaohsiung 807, TaiwanStatistical Analysis Laboratory, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, TaiwanDepartment of Business Management, National Sun Yat-Sen University, Kaohsiung 803, TaiwanSchool of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, TaiwanBackground: Ankle-brachial index (ABI) is a simple method for diagnosing peripheral artery disease (PAD) but has limited reliability in patients with diabetes mellitus (DM) because of medial artery calcification. Our study aims to investigate whether the toe brachial index (TBI) or the cardio-ankle vascular index (CAVI) has a better detection over the ABI for diagnosing PAD in diabetic kidney disease (DKD). Materials and Methods: A cohort of 368 patients (mean age 68.59 ± 13.14 years, 190 males and 178 females) with type 2 DM underwent ABI, TBI, and CAVI measurements at our outpatient clinic. Results: Of all enrolled patients, the TBI is significant in evaluating PAD, especially in patients whose chronic kidney disease (CKD) stage 3a with adjusted odds ratio (AOR) = 6.50, 95% confidence interval (CI) 1.63–25.97, <i>p</i> = 0.0080, stage 3b AOR = 7.47, 95% CI 1.52–36.81, <i>p</i> = 0.0135, and stage 4–5 AOR = 20.13, 95% CI 1.34–94.24, <i>p</i> = 0.0116. CAVI is also significant in CKD stage 1 with AOR = 0.16, 95% CI 0.03–0.77, <i>p</i> = 0.0223, stage 2 with AOR = 0.18, 95% CI 0.04–0.74, <i>p</i> = 0.0180, and stage 3a AOR = 0.31, 95% CI 0.10–0.93, <i>p</i> = 0.0375. Conclusion: TBI has a better yield of detection of PAD compared to ABI among Taiwanese patients with DKD. CAVI may play a role in the early stage of DKD.https://www.mdpi.com/2077-0383/12/23/7393peripheral artery diseasetoe-branchial indexankle-branchial indexcardio-ankle vascular indexdiabetic kidney disease |
| spellingShingle | Chia-Wei Chang Ya-Wen Sung Yu-Ting Huang Yong-Chuan Chung Mei-Yueh Lee Better Detection of Peripheral Arterial Disease with Toe-Brachial Index Compared to Ankle-Brachial Index among Taiwanese Patients with Diabetic Kidney Disease Journal of Clinical Medicine peripheral artery disease toe-branchial index ankle-branchial index cardio-ankle vascular index diabetic kidney disease |
| title | Better Detection of Peripheral Arterial Disease with Toe-Brachial Index Compared to Ankle-Brachial Index among Taiwanese Patients with Diabetic Kidney Disease |
| title_full | Better Detection of Peripheral Arterial Disease with Toe-Brachial Index Compared to Ankle-Brachial Index among Taiwanese Patients with Diabetic Kidney Disease |
| title_fullStr | Better Detection of Peripheral Arterial Disease with Toe-Brachial Index Compared to Ankle-Brachial Index among Taiwanese Patients with Diabetic Kidney Disease |
| title_full_unstemmed | Better Detection of Peripheral Arterial Disease with Toe-Brachial Index Compared to Ankle-Brachial Index among Taiwanese Patients with Diabetic Kidney Disease |
| title_short | Better Detection of Peripheral Arterial Disease with Toe-Brachial Index Compared to Ankle-Brachial Index among Taiwanese Patients with Diabetic Kidney Disease |
| title_sort | better detection of peripheral arterial disease with toe brachial index compared to ankle brachial index among taiwanese patients with diabetic kidney disease |
| topic | peripheral artery disease toe-branchial index ankle-branchial index cardio-ankle vascular index diabetic kidney disease |
| url | https://www.mdpi.com/2077-0383/12/23/7393 |
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