Pulse lineResearch With Heart Logo

Ankle-brachial index and incident diabetes mellitus: the atherosclerosis risk in communities (ARIC) study.

TitleAnkle-brachial index and incident diabetes mellitus: the atherosclerosis risk in communities (ARIC) study.
Publication TypeJournal Article
Year of Publication2016
AuthorsHua S, Loehr LR, Tanaka H, Heiss G, Coresh JJ, Selvin E
Secondary AuthorsMatsushita K
JournalCardiovasc Diabetol
Volume15
Issue1
Pagination163
Date Published2016 12 07
ISSN1475-2840
KeywordsAnkle Brachial Index, Atherosclerosis, Biomarkers, Blood Glucose, Chi-Square Distribution, Comorbidity, Diabetes Mellitus, Female, Humans, Incidence, Male, Middle Aged, Nonlinear Dynamics, Peripheral Arterial Disease, Predictive Value of Tests, Proportional Hazards Models, Risk Assessment, Risk Factors, Time Factors, United States
Abstract

BACKGROUND: Individuals with peripheral artery disease (PAD) often have reduced physical activity, which may increase the future risk of diabetes mellitus. Although diabetes is a risk factor for PAD, whether low ankle-brachial index (ABI) predates diabetes has not been studied.

METHODS: We examined the association of ABI with incident diabetes using Cox proportional hazards models in the ARIC Study. ABI was measured in 12,247 black and white participants without prevalent diabetes at baseline (1987-1989). Incident diabetes cases were identified by blood glucose levels at three subsequent visits (1990-92, 1993-95, and 1996-98) or self-reported physician diagnosis or medication use at those visits or during annual phone interview afterward through 2011.

RESULTS: A total of 3305 participants developed diabetes during a median of 21 years of follow-up. Participants with low (≤0.90) and borderline low (0.91-1.00) ABI had 30-40% higher risk of future diabetes as compared to those with ABI of 1.10-1.20 in the demographically adjusted model. The associations were attenuated after further adjustment for other potential confounders but remained significant for ABI 0.91-1.00 (HR = 1.17, 95% CI 1.04-1.31) and marginally significant for ABI ≤ 0.90 (HR = 1.19, 0.99-1.43). Although the association was largely consistent across subgroups, a stronger association was seen in participants without hypertension, those with normal fasting glucose, and those with a history of stroke compared to their counterparts.

CONCLUSIONS: Low ABI was modestly but independently associated with increased risk of incident diabetes in the general population. Clinical attention should be paid to the glucose trajectory among people with low ABI but without diabetes.

DOI10.1186/s12933-016-0476-4
Alternate JournalCardiovasc Diabetol
PubMed ID27923363
PubMed Central IDPMC5142100
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
K24 DK106414 / DK / NIDDK NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States