Prevalence of peripheral arterial disease using plethysmographic ankle‑brachial index and correlation with carotid intima‑media thickness among diabetics at the University of Benin Teaching Hospital
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Abstract
Background: Diabetes mellitus is an important risk factor for the development of atherosclerosis which leads to macrovascular and cardiovascular complications such as peripheral arterial disease (PAD). PAD has been associated with an increased risk of lower limb amputation, morbidity, and mortality from major cardiovascular events such as stroke and myocardial infarction.
Materials and Methods: This was a prospective cross‑sectional descriptive study which involved the use of an automated ankle‑brachial index (ABI) assessment known as plethysmography to determine the prevalence of PAD and to analyze the pulse volume waveform (PVW) among 100 people living with diabetes. The ABI values were correlated with the subject’s common carotid artery intima‑media thickness(CCA‑IMT). Collated data were analyzed using the Statistical Package for the Social Sciences version 20.0. Statistical tests were considered significant at P < 0.05 and 95% confidence interval.
Results: Twenty‑three (23%) had ABI of ≤ 0.9 indicating PAD, while 75 (75%) had normal ABI indicating those without the disease. The presence of PAD correlated significantly with abnormal PVW pattern (P = 0.0001). The mean CCA‑IMT from this study was 1.01 ± 0.28 mm. A statistically significant correlation was found between the PAD, mean CCA‑IMT and right CCA‑IMT (P = 0.017, r = 0.238 and P = 0.003, r = 0.290).
Conclusion: The prevalence of PAD in type 2 diabetic was found to be 23% in this study; in addition, a significant correlation of PAD with CCA‑IMT and other risk factors for diabetes was also found. Hence, screening for PAD should be done in all diabetic patients to detect this complication early.
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