Predictive value of abnormal ankle-brachial index in patients with diabetes: A meta-analysis

Nie, Fengze; Jiang, He; Cao, Hui; Hu, Xinhua

doi:10.1016/j.diabres.2021.108723

Cited by 16 publications

(7 citation statements)

References 36 publications

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“… 13 Numerous studies have showed that ABI, a fast, inexpensive and non-invasive indicator of atherosclerosis, may be a predictor of stroke recurrence. 7 , 14 Narrowing or occlusion of the peripheral arteries of the lower limbs as a result of aging, hypertension, diabetes, or other diseases, lead to a decrease in blood flow through the dorsalis pedis artery that is reflected by the changes in the ABI. 15 The normal range of ABI is 0.9-1.3, whereas an ABI<0.9 suggests possible impairment of peripheral arterial flow in the lower limbs and cerebrovascular disease.…”

Section: Discussionmentioning

confidence: 99%

“…Ankle brachial index (ABI), which refers to the ratio of ankle/dorsalis pedis artery systolic pressure to brachial artery systolic pressure, is a reliable, convenient and non-invasive method, often used for the diagnosis of peripheral artery disease. 7 The inflammatory marker lipoprotein associated phospholipase A2 (LP-PLA2) is also associated with the development of atherosclerosis and cardiovascular events and could be relevant in the prediction of acute ischemic stroke (AIS). 8 Studies show that another factor, microribonucleic acid-103 (miR-103), is involved in the atherosclerotic process and damages endothelial cells by targeting long chain non-coding RNA-WDR59 and Kruppel-like factor four, increasing chemokine and proinflammatory factors.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of ankle brachial index, serum miR-103 and LP-PLA2 in the prognosis of acute ischemic stroke

Chang,

Zhang,

Xue

et al. 2024

Pak J Med Sci

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Objective: To explore the prognostic value of ankle brachial index (ABI), serum microribonucleic acid-103 (miR-103), and lipoprotein associated phospholipase A2 (LP-PLA2) indicators in patients with acute ischemic stroke (AIS). Methods: A retrospective analysis was conducted using the medical records of 202 patients with AIS admitted to the First Affiliated Hospital of Hebei North University from June 2019 to December 2022. Patients were divided into two groups based on their prognosis: the Poor-group (n=72) and the Good-group (n=130). Levels of ABI, serum miR-103, and LP-PLA2 indicators were compared between the two groups. Multivariate logistic regression analysis was used to analyze the independent risk factors for the poor prognosis in patients with AIS, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of ABI, serum miR-103, and LP-PLA2 levels on the prognosis of AIS. Results: Seventy two patients had a poor prognosis (35.6%) and 130 had a good prognosis (64.4%). The Poor-group had a higher proportion of elderly patients, patients with a history of diabetes and hypertension, abnormal ABI, and elevations in serum miR-103 and LP-PLA2 compared to the Good-group (P<0.05). Multivariate logistic regression analysis showed that abnormal ABI, and high levels of serum miR-103 and LP-PLA2 were independent risk factors for the poor prognosis. ROC curve provided a combined AUC of 0.862, which was higher than that of the individual ABI, serum miR-103, and LP-PLA2 curves, with values of 0.625, 0.749, and 0.696, respectively (P<0.05). Conclusions: Abnormal ABI, and high serum miR-103 and LP-PLA2 levels are independent risk factors for poor prognosis in AIS patients. They can be used as important indicators for predicting the prognosis of AIS. doi: https://doi.org/10.12669/pjms.40.4.8716 How to cite this: Chang Q, Zhang F, Xue Q, Song A. Evaluation of ankle brachial index, serum miR-103 and LP-PLA2 in the prognosis of acute ischemic stroke. Pak J Med Sci. 2024;40(4):763-766. doi: https://doi.org/10.12669/pjms.40.4.8716 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of ankle brachial index, serum miR-103 and LP-PLA2 in the prognosis of acute ischemic stroke

Chang,

Zhang,

Xue

et al. 2024

Pak J Med Sci

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“…An abnormal ABI has been shown to be independently associated with CVD events in type 2 diabetes mellitus 49 , 50 , 51 , 52 . The CAVI is also used in clinical practice as a surrogate marker of CVD 53 .…”

Section: Discussionmentioning

confidence: 99%

Current status of low‐density lipoprotein cholesterol for primary prevention of coronary artery disease in late‐stage elderly persons with type 2 diabetes mellitus: A retrospective, single‐center study

Yamamoto

Ito

et al. 2022

J of Diabetes Invest

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Aims/Introduction The importance of low‐density lipoprotein cholesterol (LDL‐C) in the primary prevention of cardiovascular disease has recently been reported in the population aged ≥75 years with hypercholesterolemia. Therefore, the current status of LDL‐C management for primary prevention of coronary artery disease in patients aged ≥75 years with type 2 diabetes mellitus was investigated. Materials and Methods A total of 124 patients aged ≥75 years who had type 2 diabetes mellitus, but no coronary artery disease, were investigated. The patients' background characteristics, LDL‐C, glycemic status, ankle‐brachial index and cardio‐ankle vascular index were compared between patients taking and not taking LDL‐C‐lowering agents, such as hydroxymethylglutaryl‐CoA reductase inhibitors (statins) and ezetimibe. The details of the antihyperlipidemic and antidiabetic agents used in the present study were also examined. Results LDL‐C was significantly lower in patients taking LDL‐C‐lowering agents (LDLCLT[+]) than in patients not taking them (LDLCLT[−]), although LDL‐C was maintained <120 mg/dL in both groups (93.0 mg/dL vs 102.1 mg/dL). Approximately half of the cases in the LDLCLT(+) group received moderate‐intensity statins, with pitavastatin being the most prescribed statin. Glycated hemoglobin was significantly lower in the LDLCLT(+) group than in the LDLCLT(−) group (6.9% vs 7.3%). Sodium‐glucose transporter 2 inhibitors were more frequently used in the LDLCLT(+) group than in the LDLCLT(−) group. The ankle‐brachial index/cardio‐ankle vascular index did not differ between the groups. Conclusion Low‐density lipoprotein cholesterol was properly managed for primary prevention of coronary artery disease in patients aged ≥75 years with type 2 diabetes mellitus regardless of the presence or absence of LDL‐C‐lowering agents.

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“…Multiple studies have confirmed that abnormal ABI is associated with an increased risk of cardiovascular or all-cause mortality and major adverse cardiovascular events in diabetes patients. Subgroup analysis showed that abnormally low and high ABI had similar values in predicting cardiovascular mortality [ 25 ] and there was a U-shaped association between ABI values and cardiovascular mortality [ 26 ]. Although PAD is common in diabetics, it’s still not fully recognized, and its diagnosis is often difficult when patients have peripheral neuropathy, as the latter condition can mask pain [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

The association between time in the glucose target range and abnormal ankle-brachial index: a cross-sectional analysis

Wei

Liu

et al. 2022

Cardiovasc Diabetol

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Background Time in range (TIR), a novel proxy measure of glucose control, is found closely related to diabetic microangiopathy and some other chronic complications, but the correlation between TIR and lower limb angiopathy has not been studied yet. Our purpose is to explore the relationship between TIR and abnormal ankle-brachial index(ABI) in type 2 diabetes. Methods We retrospectively collected patients’ information from the database and performed cross-sectional analysis. A total of 405 type 2 diabetes patients were enrolled in this study. ABI was measured and patients were stratified into low, normal, and high groups according to ≤ 0.9, > 0.9 and < 1.3, ≥ 1.3 ABI values. All patients underwent continuous glucose monitoring(CGM), and TIR was defined as the percentage of time in which glucose was in the range of 3.9–10 mmol/L during a 24-h period. Correlations between TIR and abnormal ABI were analyzed using Spearman analysis. And logistic regression was used to explore whether TIR is an independent risk factor for abnormal ABI. Results The overall prevalence of abnormal ABI was 20.2% (low 4.9% and high 15.3%). TIR was lower in patients with abnormal ABI values (P = 0.009). The prevalence of abnormal ABI decreased with increasing quartiles of TIR (P = 0.026). Abnormal ABI was negatively correlated with TIR and positively correlated with hypertension, age, diabetes duration, UREA, Scr, ACR, TAR, MBG, and M values (P < 0.05). The logistic regression revealed a significant association between TIR and abnormal ABI, while HbA1C and blood glucose variability measures had no explicit correlation with abnormal ABI. Additionally, there was a significant difference in LDL between the low and high ABI groups (P = 0.009), and in Scr between normal and low groups (P = 0.007). And there were significant differences in TIR (P = 0.003), age (P = 0.023), UREA (P = 0.006), ACR (P = 0.004), TAR (P = 0.015), and MBG (P = 0.014) between normal and high ABI groups, and in diabetes duration between both normal and low (P = 0.023) and normal and high (P = 0.006) groups. Conclusions In type 2 diabetes patients, abnormal ABI is associated with lower TIR, and the correlation is stronger than that with HbA1C. Therefore, the role of TIR should be emphasized in the evaluation of lower limb vascular diseases.

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Predictive value of abnormal ankle-brachial index in patients with diabetes: A meta-analysis

Cited by 16 publications

References 36 publications

Evaluation of ankle brachial index, serum miR-103 and LP-PLA2 in the prognosis of acute ischemic stroke

Evaluation of ankle brachial index, serum miR-103 and LP-PLA2 in the prognosis of acute ischemic stroke

Current status of low‐density lipoprotein cholesterol for primary prevention of coronary artery disease in late‐stage elderly persons with type 2 diabetes mellitus: A retrospective, single‐center study

The association between time in the glucose target range and abnormal ankle-brachial index: a cross-sectional analysis

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