Decline in ankle-brachial index is stronger in poorly than in well controlled diabetes: Results from the Heinz Nixdorf Recall cohort study
| Autor: | Nils Lehmann, Knut Kröger, Bernd Kowall, Raimund Erbel, Susanne Moebus, Andreas Stang |
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| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Arterial disease Population Medizin 030204 cardiovascular system & hematology Cohort Studies Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Diabetes Mellitus medicine Humans Ankle Brachial Index cardiovascular diseases education Aged Glycated Hemoglobin education.field_of_study Recall business.industry Middle Aged medicine.disease Confidence interval body regions 030104 developmental biology medicine.anatomical_structure Female Ankle Cardiology and Cardiovascular Medicine business human activities Diabetic Angiopathies Cohort study |
| Zdroj: | Atherosclerosis. 284:37-43 |
| ISSN: | 0021-9150 |
| Popis: | The ankle-brachial index (ABI) is a marker of atherosclerosis and a diagnostic criterion for peripheral arterial disease (PAD). We studied the association between HbA1c and ABI in subjects with and without diabetes.In the Heinz Nixdorf Recall Study, a population-based cohort study in Germany (N = 4,814, age 45-75 years), ABI was measured at baseline, at 5- and 10-year follow-up. Subjects with ABI0.9, ABI1.4 or self-reported PAD at baseline were excluded from analyses. In 3199 participants, we assessed associations between HbA1c and incident PAD (ABI 0.9) and change in ABI, respectively, using logistic and linear regression models. Subjects without diabetes, with HbA1c5.7% were used as reference group.Compared to the reference group, 10-year decline in ABI was -0.066 (95% confidence interval: -0.117; -0.016) and -0.021 (-0.063; 0.021) in subjects with poorly (≥7.0% HbA1c) and well (7.0% HbA1c) controlled previously known diabetes; -0.010 (-0.054; 0.034) in those with newly detected diabetes diagnosed by HbA1c ≥ 6.5%, and -0.005 (-0.023; 0.013) in those without diabetes, with HbA1c 5.7-6.4%. For poorly controlled diabetes, odds ratios for low ABI (0.9) were 3.5 (1.6-7.9), and 3.1 (1.3-7.0) after 5- and 10-year follow-up, respectively. The incidence of Mönckeberg disease (ABI 1.4) was low (6/288 (2.4%) over 5 years).Decline in ABI was stronger in poorly than well-controlled diabetes. Subjects with newly detected diabetes diagnosed by the new HbA1c criterion (≥6.5%) did not show an increased decline in ABI over 10 years. |
| Databáze: | OpenAIRE |
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