Background: Introducing an accurate method with minimal invasiveness to evaluate vascular involvement in diabetic patients is essential. This study aimed to evaluate the Ankle-Brachial Index (ABI) in diabetic patients without vascular symptoms of the lower extremities.
Materials and Methods: A descriptive-analytical study was performed in 2020 on 339 lower extremities of diabetic patients without peripheral vascular involvement and a history of cardiovascular disease, referred to clinics or emergency rooms of selected hospitals in Ahvaz. After recording demographic information and clinical sign/symptom: Pain, paresthesia, vascular ulcers, pallor, no capillary filling, ABI and lower vascular Doppler were recorded, also. Mann-Whitney and independent t-test, Pearson correlation and Rock curve were used to compare data.
Results:  Out of 339 Dopplers, 42 cases (12.4%) were abnormal and out of these 42 cases, 33 cases (9.7%) were severe and 9 cases (2.7%) were mild. Other findings of the study showed that the mean ABI in patients with abnormal Doppler was significantly lower than patients with normal Doppler (0.93 vs. 1.13). In the study based on the severity of vascular involvement, the lowest ABI was observed in patients with severe involvement (0.88). However diagnostic power of ABI in the diagnosis of abnormal Doppler at the cut-off point of 1.085 was low, that the sensitivity and specificity to 59.5% and 81.5% were obtained, respectively. Its positive and negative predictive values were 31.3% and 93.4%, respectively. The overall accuracy of the test was 78.7%. Finally, it was found that ABI has a direct and significant relationship with age and an inverse and significant relationship with creatinine.
Conclusion: Based on the findings of this study, reduction of ABI in patients with peripheral vascular involvement occurs in asymptomatic diabetic patients but does not have high diagnostic power in diagnosing abnormal Doppler cases and other methods should be used in addition to it.