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[Ankle-brachial index associated with diabetic foot: case-control study]
Olga Rosa Brito-Zurita1, Salvador Ortega-López, David López del Castillo-Sánchez
1Unidad de Investigación en Epidemiología Clínica del Hospital de Especialidades No. 2, Unidad Médica de Alta Especialidad, IMSS, Sonora. México.
Introduction:
The diabetic foot has been associated with substantial morbidity and mortality in diabetic patients. The ankle-brachial index is a simple diagnostic method for peripheral arterial disease.
Objective:
to evaluate the usefulness of the physical ankle-brachial index and known risk factors in the development of diabetic foot.
Methods:
In a case-control study, we studied 60 diabetic patients between 20 and 70 years old who were divided according to the presence of diabetic foot (cases); controls were assigned for patients without injury to their feet or other morbidities. The variables studied included: glucose, cholesterol, triglycerides, body mass index, blood pressure, ankle-brachial index, physical exercise, smoking, and alcoholism.
Results:
Mean age was 55 years for cases and 56 for controls (p = 0.548), with an average of disease progression 15 years for both groups. No differences in metabolic variables were found. A history of smoking (OR = 4.8, 95% CI = 1.50 to 15.80, p = 0,006) and an ankle-brachial index = 0.9 left (OR = 10.6, 95% CI = 1.80 to 55.60, p = 0.004) or right (OR = 5.2, 95% = 1.16 to 24.00, p = 0.049) were associated with development of peripheral arterial disease. Instead, the exercise proved to be a protective factor.
Conclusions:
The ankle-brachial index, should be used in primary care clinics for the study of the arterial circulation of the lower limbs, especially in patients with diabetes mellitus of medium and long evolution or cardiovascular risk factors.
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Prepare for the Procedure:
Assessment of blood pressure in brachial artery(two-step method)
