Relationships and Synergistic Effects of Body Mass Index and Blood Glucose Marker on the Ankle-Brachial Index in Adult With Type 2 Diabetes Mellitus: A Cross-Sectional Study.

Abstract

This study aimed to identify the independent and synergistic effects of body mass index, fasting blood glucose, and hemoglobin A1c on ankle-brachial index in type 2 diabetes mellitus. This cross-sectional study involved 1096 participants who were measured using questionnaires, a digital scale, and a height measurement device. Blood marker was examined using fasting venous blood. The ankle-brachial index was measured using Doppler ultrasound. A multinomial logistic regression was applied for adjusting confounders. Participants who were obese significantly increased 2.12- and 1.86-fold risk of a low and a high ankle-brachial index (p <  0.05), respectively. Participants with abnormal fasting blood glucose significantly increased 1.79- and 2.05-fold risk of a low and a high ankle-brachial index (p <  0.05). Participants with hemoglobin A1c > 6.5% significantly increased 1.71- and 1.76-fold risk of a low and a high ankle-brachial index (p <  0.05), respectively. Participants with abnormalities for all three indices synergistically increased 12.31- and 5.31-fold risk of a low and a high ankle-brachial index (p <  0.001), respectively. Abnormal body mass index, fasting blood glucose, and hemoglobin A1c readings significantly, independently, and synergistically increased the risk of an abnormal ankle-brachial index.