2013, Number 2
<< Back Next >>
Cir Cir 2013; 81 (2)
Ankle-brachial index associated with diabetic foot: case-control study
Brito-Zurita OR, Ortega-López S, López del Castillo-Sánchez D, Vázquez-Téllez AR, Ornelas-Aguirre JM
Language: Spanish
References: 29
Page: 131-137
PDF size: 1026.82 Kb.
ABSTRACT
Introduction: The diabetic foot has been associated with substantial morbidity and mortality in diabetic patients. The anklebrachial index is a simple diagnostic method for peripheral arterial disease.
Objective: to evaluate the usefulness of ankle-brachial index physical 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 in 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 available in the clinical of primary care for the study of arterial circulation of the lower limbs, especially in patients with diabetes mellitus of medium and long evolution and/or risk factors cardiovascular.
REFERENCES
Cueva-Arana V, Mejía-Mejía J, Luengas-Valverde HD, Salinas-Sandoval O. Complicaciones del pie diabético. Factores de riesgo asociados. Rev Med IMSS 2003;41(2):97-104.
González-Expósito A, Carballosa-Peña E, González-Rodríguez D. Morbilidad por el síndrome de pie diabético. Rev Cubana Angiol y Cir Vasc 2003;4:1-7.
Fleming DM, Schellevis FG, Van Casteren V. The prevalence of known diabetes in eight European countries. Eur J Public Health 2004;14(1):10-14.
Tabatabaei Malazy O, Mohajeri-Tehrani MR, Pajouhi M, Shojaei Fard A, Amini MR, Larijani B. Iranian Diabetic Foot Research Network. Adv Skin Wound Care 2010;23(10):450-454.
Sell-Lluveras JL, Domínguez IM. Guía práctica para el diagnóstico y el tratamiento del síndrome del pie diabético. Rev Cub Endocrinol 2001;12(3):188-197.
Schaper NC, Apelqvist J, Bakker K. The International Consensus and Practical Guidelines on the Management and Prevention of the Diabetic Foot. Curr Diab Rep 2003;3(6):475-479.
McInnes AD, Hashmi F, Farndon LJ, Church A, Haley M, Sanger DM, et al. Comparison of shoe-length fit between people with and without diabetic peripheral neuropathy: a case-control study. J Foot Ankle Res 2012;5:9.
Pecoraro RE, Reiber GE, Burgess EM. Pathways to Diabetic Limb Amputation. Basis for Prevention. Diabetes Care 1990;13(5):513-521.
Nather A, Bee CS, Huak CY, Chew JL, Lin CB, Neo S, et al. Epidemiology of diabetic foot problems and predictive factors for limb loss. J Diabetes Complications 2008;22(2):77-82.
Tahrani AA, McCarthy M, Godson J, Taylor S, Slater H, Capps N, et al. Diabetes care and the new GMS contract: the evidence for a whole county. Br J Gen Pract 2007;57(539):483-485.
Rathur HM, Boulton AJM. The neuropathic diabetic foot. Nat Clin Pract Endocrinol Metab 2007;3(1):14-25.
Nather A, Chionh SB, Tay PL, Aziz Z, Teng JW, Rajeswari K, et al. Foot screening for diabetics. Ann Acad Med Singapore 2010;39(6):472-475.
Papanas N, Symeonidis G, Mavridis G, Georgiadis GS, Papas TT, Lazarides MK, et al. Ankle-Brachial Index: a Surrogate Marker of Microvascular Complications in Type 2 Diabetes Mellitus? Int Angiol 2007;26(3):253-257.
Wagner FW Jr. The dysvascular foot: a system for diagnosis and treatment. Foot Ankle 1981;2(2):64-122.
Lijmer JG, Hunink MG, van den Dungen JJ, Loonstra J, Smit AJ. ROC analysis of noninvasive tests for peripheral arterial disease. Ultrasound Med Biol 1996;22(4):391-398.
Begelman SM, Jaff MR. Noninvasive diagnostic strategies for peripheral arterial disease. Cleve Clin J Med 2006;73(Suppl 4):S22-S29.
Newman AB, Siscovick DS, Manolio TA, Polak J, Fried LP, Borhani NO, et al. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Cardiovascular Heart Study (CHS) Collaborative Research Group. Circulation 1993;88(3):837-845.
Blanes JI, Representatives of Spanish Society of Surgeons (ACS), Representatives of Spanish Society of Angiology and Vascular Surgery (SEACV), Representatives of Spanish Society of Emergency Medicine (SEMES), Spanish Internal Medicine Society (SEMI), Representatives of Spanish Society of Critical Care Medicine and Coronary Units (SEMICYUC), et al. Consensus document on treatment of infections in diabetic foot. Rev Esp Quimioter 2011;24(4):233-262.
Salinas-Martínez AM, Amaya-Alemán MA, Arteaga-García JC, Núñez-Rocha GM, Garza-Elizondo ME. Eficiencia técnica de la atención al paciente con diabetes en el primer nivel. Salud Publica Mex 2009;51(1):48-58.
Williams LH, Rutter CM, Katon WJ, Reiber GE, Ciechanowski P, Heckbert SR, et al. Depression and Incident Diabetic Foot Ulcers: A Prospective Cohort Study. Am J Med 2010;123(8):748-754.e3.
Boyko EJ, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ. Prediction of Diabetic Foot Ulcer Occurrence Using Commonly Available Clinical Information. The Seattle Diabetic Foot Study. Diabetes Care 2006;29(6):1202-1207.
Bhasin N, Scott DJA. Ankle Brachial Pressure Index: identifying cardiovascular risk and improving diagnostic accuracy. J R Soc Med 2007;100(1):4-5.
Vicente I, Lahoz C, Taboada M, Laguna F, García-Iglesias F, Mostaza-Prieto JM. Ankle-brachial index in patients with diabetes mellitus: prevalence and risk factors. Rev Clin Esp 2006;206(5):225-229.
Olin JW, Allie DE, Belkin M, Bonow RO, Casey DE Jr, Creager MA, et al. ACCF/AHA/ACR/SCAI/SIR/SVM/SVN/SVS 2010 performance measures for adults with peripheral artery disease. J Vasc Surg 2010;52(6):1616-1652.
Manzano L, Mostaza JM, Suarez C, Del Valle FJ, Ortiz JA, Sampedro JL, et al. Prognostic value of the ankle-brachial index in elderly patients with a stable chronic cardiovascular event. J Thromb Haemost 2010;8(6):1176-1184.
Resnick HE, Carter EA, Sosenko JM, Henly SJ, Fabsitz RR, Ness FK, et al. Incidence of Lower-Extremity Amputation in American Indians. The Strong Heart Study. Diabetes Care 2004;27(8):1885-1891.
Tuttle LJ, Sinacore DR, Cade WT, Mueller MJ. Lower Physical Activity Is Associated With Higher Intermuscular Adipose Tissue in People With Type 2 Diabetes and Peripheral Neuropathy. Phys Ther 2011;91(6):923-930.
Kruse RL, LeMaster JW, Madsen RW. Fall and Balance Outcomes After an Intervention to Promote Leg Strength, Balance, and Walking in People With Diabetic Peripheral Neuropathy: “Feet First” Randomized Controlled Trial. Phys Ther 2010;90(11):1568-1579.
Najafi B, Crews RT, Wrobel JS. Importance of Time Spent Standing for Those at Risk of Diabetic Foot Ulceration. Diabetes Care 2010;33(11):2448-2450.