Toe-brachial index is beyond a peripheral issue in patients with type 2 diabetes

Background Atherosclerosis is the leading cause of death in patients with diabetes. We aimed to evaluate the association between ankle-brachial index (ABI) and toe-brachial index (TBI) with carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM). Methods This cross sectional study included 296 patients with T2DM who met the American Diabetes Association criteria for the assessment of peripheral arterial atherosclerosis. The ABI � 0.9 and TBI � 0.7 were considered as abnormal values. Linear and logistic regression analyses were performed to evaluate the association between TBI/ABI and CIMT. Results Right CIMT was significantly greater in the low TBI group (p = 0.03) while, left CIMT did not show a significant difference. Each 0.1-unit decrease in TBI value was independently associated with 0.017 mm increase in the right CIMT (β ± SE; -0.017 ± 0.005, p = 0.002) and with odds of the presence of increased CIMT odds ratio and 95% confidence interval: 1.21 (1.02, 1.44) after adjustment with all traditional risk factors. There was not any significant association between ABI and increased CIMT. Conclusions Beyond a suitable tool for the diagnosis of peripheral artery disease in patients with T2DM, TBI can be applied for prediction of subclinical carotid atherosclerosis. © 2021 Darban Hosseini Amirkhiz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited