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

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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.

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