Predictive value of ankle-brachial index and blood glucose on the outcomes of six-year all-cause mortality and cardiovascular mortality in a Chinese population of type 2 diabetes patients

Int Angiol. 2012 Dec;31(6):586-94.

Abstract

Aim: The aim of this paper was to investigate the predictive value of ankle-brachial index (ABI) and blood glucose to estimate mortality in Chinese type 2 diabetes patients.

Methods: Chinese type 2 diabetes patients (1706 subjects) were followed up for about 6 years,

Results: One thousand four hundred fourteen were included in the final statistical analysis during a median follow-up of 69 months. Overall, 398 patients died during follow-up and 254 deaths were attributable to cardiovascular disease (CVD). Relative risks of all-cause and CVD mortality of patients with ABI≤0.4 were increased by 2.073-fold (95% CI: 1.236-3.478) and 3.086-fold (95% CI: 1.702-5.595), compared with those of patients with ABI>1.0 and ≤1.4. Mortality was significantly increased with increasing plasma glucose and decreasing ABI. All-cause and CVD mortality was the highest (55.6% and 44.4%) with ABI≤0.4 and plasma glucose >10 mmol/L simultaneously. Relative risks of all-cause and CVD mortality in these patients were increased by 3.905-fold (95% CI: 1.334-11.431) and 3.771-fold (95% CI: 1.079-13.171), compared with patients with ABI>1.0 and ≤1.4, and plasma glucose ≤6 mmol/L simultaneously. Models to evaluate additional predictive value of ABI for mortality of type 2 diabetes patients suggested that addition of ABI significantly improved the prediction of the death rate compared with the model including conventional risk factors only.

Conclusion: High plasma glucose and low ABI had synergistic effects on increasing mortality of type 2 diabetes patients. The addition of ABI can significantly improve the prediction of mortality compared to protocol using conventional risk factors only.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ankle Brachial Index*
  • Asian Continental Ancestry Group*
  • Biomarkers / blood
  • Blood Glucose / analysis*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / mortality*
  • Cause of Death
  • Chi-Square Distribution
  • China / epidemiology
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / mortality*
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors

Substances

  • Biomarkers
  • Blood Glucose