Blood pressure as a marker of subclinical atherosclerosis in prediabetes

Objective. To determine clinical importance of carotid intima-media thickness (CIMT), ankle-brachial pressure index (ABPI) and blood pressure index (BPI) as indicators of subclinical atherosclerosis in pre-diabetic, diabetic and non-diabetic patients. Material and methods. We conducted age-and gender-adjusted case-control study. The CIMT was measured by ultrasound and portable Doppler device for detecting ABPI. The BPI was calculated as systolic blood pressure divided into diastolic blood pressure. Results. CIMT and BPI were significantly higher in subjects with prediabetes and diabetes (p<0.05 and p<0.001, respectively). ABPI was higher in subjects with diabetes (p<0.05). There were significant positive correlations between CIMT and HbA1c (r=0.416, p<0.01), ABPI and HbA1c (r=0.229, p<0.05), BPI and HbA1c (r=0.342, p<0.01). ROC analysis was applied to estimate predictive ability of novel and traditional indices. Optimal cut-off value for BPI was 1.81 with a sensitivity of 70.0% and a specificity of 60.0% (AUC=0.664, p<0.001). Conclusion. Although CIMT increase as one of the indicators of subclinical atherosclerosis was observed in diabetic and prediabetic patients, increased ABPI was seen in diabetic patients only. BPI may be a novel alternative marker for identifying subclinical atherosclerosis in prediabetes.