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Overview
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  9. Predictive And Prognostic Markers
  11. Comparison Of The Prognostic Value Of Different Arterial Sites Atherosclerosis Risk Markers For Development Of Macro- And Microvascular Complications In Individuals With Type 2 Diabetes: The Rio De Janeiro Type 2 Diabetes Cohort Study

Comparison of the prognostic value of different arterial sites atherosclerosis risk markers for development of Macro- and microvascular complications in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort study

Claudia R L Cardoso1, Nathalie C Leite1, Alan C de Souza1

  • 1Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Brazil.

Diabetes Research and Clinical Practice
|June 11, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

For type 2 diabetes patients, ankle-brachial index (ABI) best predicts cardiovascular events and death. Carotid atherosclerosis markers are superior for predicting microvascular issues like retinopathy and kidney disease.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Vascular Biology

Background:

  • Preclinical atherosclerosis risk markers include aortic stiffness, ankle-brachial index (ABI), and carotid atherosclerosis.
  • Their comparative prognostic value for macro- and microvascular outcomes in type 2 diabetes is not well-established.

Purpose of the Study:

  • To compare the prognostic importance of ABI, aortic stiffness, and carotid atherosclerosis for cardiovascular, mortality, and microvascular outcomes in individuals with type 2 diabetes.

Main Methods:

  • A prospective cohort study of 479 individuals with type 2 diabetes followed for 12 years.
  • Baseline measurements of ABI, aortic stiffness, and carotid atherosclerosis (intima-media thickness, plaques).
  • Cox regressions and risk stratification indices (C-statistics, IDI/NRI) assessed associations with outcomes.
Keywords:
Ankle-brachial indexAortic stiffnessCardiovascular eventsCarotid atherosclerosis

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Main Results:

  • ABI was the strongest predictor of cardiovascular/mortality outcomes (HRs 1.18-1.40, IDIs 10%-15%).
  • Carotid atherosclerosis markers predicted microalbuminuria (HRs 1.29-1.37, IDIs 15%-26%) and retinopathy.
  • No significant difference was found for aortic stiffness.

Conclusions:

  • Ankle-brachial index (ABI) is the optimal risk marker for cardiovascular and mortality outcomes in type 2 diabetes.
  • Carotid atherosclerosis markers are superior for predicting microvascular complications, specifically retinopathy and microalbuminuria.
Cohort study
Mortality
Risk markers
Type 2 diabetes