Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, PR China.
Department of Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China.
Diabetes Res Clin Pract. 2021 Apr;174:108723. doi: 10.1016/j.diabres.2021.108723. Epub 2021 Feb 27.
This meta-analysis aimed to examine the association of abnormal ankle brachial index (ABI) with adverse prognosis in patients with diabetes.
We systematically searched PubMed and Embase databases from inception to October 31, 2020 for observational studies investigating the predictive utility of abnormal ABI in patients with diabetes. The normal ABI is usually defined by 0.9-1.3 or 1.4.
Data were collected from 9 studies involving 9673 patients. When compared with the reference normal ABI, abnormal ABI was associated with a higher risk of cardiovascular mortality (risk ratio [RR] 1.98; 95% confidence intervals [CI] 1.66-2.37), all-cause mortality (RR 2.12; 95% CI 1.81-2.49), and major adverse cardiovascular events ([MACEs] RR 2.37; 95% CI 1.73-3.26). Subgroup analysis indicated that the pooled RR of cardiovascular mortality was similar in individuals with abnormally low ABI (RR 1.98; 95% CI 1.64-2.39) or high ABI (RR 2.00; 95% CI 1.12-3.59).
Abnormal ABI independently predicts subsequent risk of cardiovascular or all-cause mortality and MACEs in patients with diabetes. However, the predictive role of abnormal ABI is largely dominated by the low ABI rather than the high ABI.
本荟萃分析旨在探讨异常踝臂指数（ABI）与糖尿病患者不良预后的关系。
我们系统地检索了 PubMed 和 Embase 数据库，从建库至 2020 年 10 月 31 日，以寻找评估异常 ABI 对糖尿病患者预测价值的观察性研究。正常 ABI 通常定义为 0.9-1.3 或 1.4。
共有 9 项研究的数据被纳入，共 9673 例患者。与参考正常 ABI 相比，异常 ABI 与心血管死亡率（风险比 [RR] 1.98；95%置信区间 [CI] 1.66-2.37）、全因死亡率（RR 2.12；95% CI 1.81-2.49）和主要不良心血管事件（MACEs；RR 2.37；95% CI 1.73-3.26）风险升高相关。亚组分析表明，异常低 ABI（RR 1.98；95% CI 1.64-2.39）或高 ABI（RR 2.00；95% CI 1.12-3.59）患者的心血管死亡率汇总 RR 相似。
异常 ABI 独立预测糖尿病患者心血管或全因死亡率及 MACEs 的发生风险。然而，异常 ABI 的预测作用主要由低 ABI 主导，而非高 ABI。
