Correlation between ankle-brachial index and microalbuminuria in type 2 diabetes mellitus

Microalbuminuria is a reliable marker of diabetic
nephropathy. Establishment of peripheral vascular complications
leads to early diagnosis, prevention, and treatment of renal and
cardiovascular complications. This study investigated the value
of ankle-brachial index (ABI) for prediction of microalbuminuria
in type 2 diabetic patients.
Materials and Methods. Measurement of ABI with color Doppler
ultrasonography was carried out for 206 patients with type 2 diabetes
mellitus. An ABI Index less than 0.9 was defined as a predictive
marker for atherosclerosis. Microalbuminuria and risk factors of
atherosclerosis were compared between the patients categorized
based on the ABI values.
Results. The mean ABI was 1.1 ± 0.2 (range, 0.052 to 1.6), and
41 (20%) had an abnormal ABI (< 0.9). The correlations were
significant between abnormal ABI and duration of disease (P = .04),
cardiovascular event and cardiac care unit admission (P = .001),
hypertension (P = .01), and dyslipidemia (P = .01). There was a
significant correlation between ABI and microalbuminuria (odds
ratio, 0.05; 95% confidence interval, 0.038 to 0.630; P < .001). A
cutoff point of an ABI less than or equal to 1.04 had a sensitivity of
71.6% and a specificity of 64.2% for prediction of microalbuminuria.
Conclusions. The ABI is a noninvasive and reliable assay for
detection of peripheral and cardiovascular complications, and also
early stage of nephropathy in diabetic patients. In patients with
an abnormal ABI, long-term follow-up for earlier detection and
prevention of complications is helpful