Khan Shair Zaman, Waris Nazish, Miyan Zahid, Ulhaque Muhammad Saif, Fawwad Asher
Dr. Shair Zaman Khan, FCPS, Endocrine Fellow (BIDE). Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University (BMU), Karachi, Pakistan.
Dr. Awn Bin Zafar, MCPS, M.D. Assistant Professor, Department of Medicine (BMU), Consultant Physician (BIDE) Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University (BMU), Karachi, Pakistan.
Pak J Med Sci. 2019 Jul-Aug;35(4):1167-1172. doi: 10.12669/pjms.35.4.30.
To compare the difference between an automated oscillometric ABI measurement as compared to standard hand-held doppler ABI in patients with Type-2 diabetes.
This prospective study was conducted at foot clinic of Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University (BMU), a tertiary care unit, Karachi-Pakistan. The duration of study was February 2018 to March 2018. Patients with Type-2 diabetes attending the outpatient department (OPD) of foot clinic, irrespective of their symptoms were included. Baseline demographic, anthropometric measurements and biochemical parameters were recorded. The ABI was calculated with both devices by an automated oscillometric machine and standard hand-held doppler with the same investigator.
Total of 93 patients with Type-2 diabetes, 18 (19.4%) females and 75(80.6%) males were recruited. Mean age was 54.67±9.59 years and mean systolic/diastolic blood pressure was 131.38±20.2/ 80.36±10.23mmHg. Most of the patients had poor glycemic control at presentation with a mean HbA1c of 9.56±2.44%. Mean standard handheld doppler ABI and automated oscillometric ABI was 1.28±1.08 and 1.07±0.23 for right foot (mean difference = 0.21; P= 0.075), and 1.14±0.45 and 1.1±0.25 for left foot (mean difference =0.04; P=0.434), respectively. Similarly, sensitivity and specificity between two modalities was observed 60% and 93.90% for right foot, meanwhile, 60% and 97.40% for left foot, respectively.
An automated oscillometric method is comparable with standard handheld-doppler method. It is cost effective, convenient and less time consuming, can be widely used to measure ABI without special training.
比较2型糖尿病患者中自动振荡式踝臂指数（ABI）测量与标准手持式多普勒ABI测量之间的差异。
本前瞻性研究在巴基斯坦卡拉奇三级医疗单位巴凯医科大学巴凯糖尿病与内分泌研究所（BIDE）的足部诊所进行。研究时间为2018年2月至2018年3月。纳入在足部诊所门诊就诊的2型糖尿病患者，无论其有无症状。记录基线人口统计学、人体测量学指标和生化参数。由同一名研究人员使用自动振荡式仪器和标准手持式多普勒仪分别计算ABI。
共招募了93例2型糖尿病患者，其中女性18例（19.4%），男性75例（80.6%）。平均年龄为54.67±9.59岁，平均收缩压/舒张压为131.38±20.2/80.36±10.23mmHg。大多数患者就诊时血糖控制不佳，平均糖化血红蛋白（HbA1c）为9.56±2.44%。右脚的平均标准手持式多普勒ABI和自动振荡式ABI分别为1.28±1.08和1.07±0.23（平均差值=0.21；P=0.075），左脚的分别为1.14±0.45和1.1±0.25（平均差值=0.04；P=0.434）。同样，两种测量方式对右脚的敏感性和特异性分别为60%和93.90%，对左脚的分别为60%和97.40%。
自动振荡式方法与标准手持式多普勒方法相当。它具有成本效益、方便且耗时少，无需特殊培训即可广泛用于测量ABI。
