2型糖尿病患者发生糖尿病足高危因素的临床分析

目的探讨2型糖尿病患者糖尿病足的发病情况及相关危险因素,为临床治疗和预防糖尿病足提供依据。方法选择226例2型糖尿病患者,按照有无合并糖尿病足分为两组,回顾性分析其各项临床指标及糖尿病肾病、糖尿病视网膜病变、糖尿病周围神经病变等因素对糖尿病足发生的影响。结果15％的2型糖尿病患者出现糖尿病足。糖尿病足组与非糖尿病足组相比,其病程、餐后2小时血糖、糖化血红蛋白、血肌酐、尿素氮、尿白蛋白、糖尿病肾病、糖尿病视网膜病变、糖尿病周围神经病变等因素的差异有统计学意义（P均〈0．05）。其中病程、糖尿病。肾病、糖尿病视网膜病变、糖尿病周围神经病变进人回归模型并具有统计学意义（P〈0．01）。结论糖尿病的病程、肾病、视网膜病变、周围神经病变是糖尿病足发生的独立危险因素。     

2型糖尿病患者血清炎症因子水平的变化及对心脑血管病变的影响

目的观察2型糖尿病患者血清炎症因子水平的变化,探讨炎症因子对2型糖尿病尤其老年患者合并心脑血管病变的影响。方法103例2型糖尿病患者按年龄及是否合并心脑血管病变进行分组。用自动生化分析仪测定所有患者血清超敏C反应蛋白（Hs-CRP）、空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯（TG）、低密度脂蛋白-胆固醇水平,用ELISA方法测定血清白介素-6（IL-6）和肿瘤坏死因子-a（TNF-Q）水平。结果（1）2型糖尿病患者年龄≥65岁者,血清Hs-CRP、TNF-q、IL-6水平均高于年龄〈65岁者（P=0．003,P=0．001,P=0．007）。（2）合并心脑血管病变者,血清Hs-CRP水平高于无心脑血管病变者（P=0．015）。且年龄≥65岁合并心脑血管病变者,血清Hs-CRP水平高于无心脑血管病变者（P=0．040）。（3）血清Hs-CRP水平与年龄和血清TG水平呈正相关（r=0．257,P=0．000;rE0．220,P=0．003）。影响Hs-CRP的因素主要为年龄,回归方程为Y（Hs-CRP）=2．407＋0．100X（年龄）。（4）2型糖尿病中年龄≥65岁者合并心脑血管病变的发生率高于年龄〈65岁者（P=0．000）。结论炎症因子CRP、TNF-a、IL-6与老年2型糖尿病合并心脑血管病变密切相关;增龄是血清Hs-CRP水平升高的主要影响因素。     

有心血管危险因素的老年糖尿病患者有更高的下肢动脉病变患病率

目的 调查和分析老年糖尿病患者下肢动脉病变（PAD）的大血管危险因素。方法 采用多普勒血流探测仪测定了505例糖尿病患者的踝肱指数（ABI）,以比值〈0．9为PAD组,ABI≥0．9为非PAD组;年龄≥60岁为老年组,〈60岁为中青年组;同时对相关大血管危险因素进行分析。结果 老年组合并PAD65例,占33．33％;中青年组合并PAD33例,占10．65％。老年组中合并PAD与同组非PAD的患者比较,前者的病程长,空腹血糖、HbAlc、尿A／C的对数值、尿酸、超敏C反应蛋白明显增高,HDL-C、舒张压明显降低,有更高的吸烟率及冠心病合并率。随着动脉硬化的危险因素的增加,老年PAD的患病率显著增加。结论 高达三分之一的老年糖尿病患者合并PAD,合并多种心血管危险因素集簇的老年糖尿病患者有更高的PAD患病率,尿酸和C反应蛋白与下肢动脉硬化明显相关。     

血糖失控的住院中老年2型糖尿病患者临床特点分析

目的分析血糖失控的住院中老年2型糖尿病患者临床特点及慢性并发症情况。方法住院2型糖尿病（T2DM）患者449例,年龄≥40岁,糖化血红蛋白≥7．5％,根据病史分为新诊断糖尿病和已诊断糖尿病,按年龄进一步分为中年亚组与老年亚组,比较中老年患者临床特点,并分析糖尿病慢性并发症的发生状况。结果（1）所有中老年患者中新诊断糖尿病组糖化血红蛋白（HbAlc）、糖化血清蛋白（GA）比已诊断糖尿病组增高;（2）研究对象中糖尿病肾病（DN）、糖尿病视网膜病变（DR）、糖尿病周围神经病变（DPN）、周围血管病变（PVD）检出频率分别为19．4％、32．7％、17．4％、52．1％;（3）新诊断糖尿病组大于45％的患者至少存在一种慢性并发症,已诊断糖尿病组大于33％的老年患者合并2种或2种以上并发症。结论新诊断糖尿病人群应早期进行慢性并发症筛查;老年患者合并多种慢性并发症的频率较高,除有效控制血糖外,要注重多重危险因素干预,延缓慢性并发症的发生、发展。     

2型糖尿病周围神经病变患者尿山梨醇排泄的变化

目的探讨2型糖尿病患者尿山梨醇与周围神经病变（DPN）的关系。方法采用固相夹心酶联免疫吸附法测定63例2型糖尿病患者（无DPN组）,134例2型糖尿病周围神经病变患者（DPN组）和72例正常对照组的24h尿山梨醇排泄量,并分析其与病程、血糖、糖化血红蛋白、血清胰岛素、甘油三酯、总胆固醇、尿白蛋白排泄率（UAER）和神经传导速度的关系。结果2型糖尿病DPN患者尿山梨醇水平高于无DPN组和正常对照组（P〈0．05或〈0．01）;2型糖尿病患者尿山梨醇水平与神经传导速度呈负相关,与病程和UAER（P〈0．05或〈0．01）呈正相关。结论尿山梨醇可作为2型糖尿病周围神经病变的检测指标。     

踝臂指数与冠状动脉复杂病变的相关性研究

目的探讨踝臂指数（ABI）与冠状动脉（冠脉）病变程度的关系。方法对纳入研究的185例患者收集其基本资料、测量ABI、行冠脉造影,ABI〈0．9者为研究组（52侧）,ABI≥0．9者为对照组（133例）,应用多变量Logistic回归分析两组ABI与冠心病危险因子及冠脉病变程度的相关性。结果两组的病变血管支数比较,两组3支病变、B2／C型复杂病变例数比较,差异均有统计学意义（P〈0．01）;多个心血管危险因子与ABI〈0．9存在相关性,ABI〈0．9是冠脉3支病变及B2／C型复杂病变的独立预测因子（OR值分别为3．845、3．012）。结论ABI〈0．9一定程度上能够预测冠脉复杂病变（3支病变及B2／C型复杂病变）。     

血清25羟维生素D3与2型糖尿病周围神经病变的相关性

目的：探讨血清25OH维生素D3（25OHD3）水平与2型糖尿病周围神经病变的关系。方法收集114例2型糖尿病患者,根据临床症状、体征和电生理检查,将患者分为糖尿病合并周围神经病变组（63例）和非糖尿病周围神经病变组（51例）,抽取所有受试者空腹静脉血检测血清25OHD3水平,比较2组患者血清25OHD3水平,分析25OHD3与2型糖尿病临床指标间的相关性。结果糖尿病周围神经病变组较非糖尿病周围神经病变组患者维生素D3缺乏发生率分别是79.4％和41.2％,差异有统计学意义（P＜0.01）;糖尿病周围神经病变组患者25OHD3水平低于非糖尿病周围神经病变组,分别为（40.1±12.7）nmol/L与（54.4±18.4）nmol/L,差异有统计学意义（P＜0.01）;25OHD3水平与2型糖尿病患者糖化血红蛋白（HbA1c）及糖尿病病程负相关（P值分别为0.01和0.044）。结论低25OHD3水平是2型糖尿病周围神经病变的危险因素,25OHD3水平与2型糖尿病患者病程和HbA1c相关。     

导致2型糖尿病心血管自主神经病变的主要危险因素及其对病情评估的价值

目的分析2型糖尿病中影响心血管自主神经病变（CAN）的危险因素,探讨这些因素对CAN的危害程度,并建立回归模型。方法325例2型糖尿病患者根据心血管自主神经功能试验结果分为：正常组、早期病变组、确诊组和严重组。对所有患者询问病史、体格检查、生化检查及ECG、神经传导速度、眼底镜检查、颈动脉和下肢动脉Doppler检查。结果64．0％的病人存在自主神经病变,30．2％确诊为CAN;相关指标随自主神经病变程度加重而恶化;等级回归显示,年龄、平均糖化血红蛋白、高血压、周围神经病变、视网膜病变、静息心动过速和周围神经病变病程是显著影响因素（P〈0．05）;根据这些因素,建立数学模型,可推算患者自主神经病变的病情。结论除年龄和血压外,其他自主神经病变的影响因素都与血糖有关,进一步证实控制血糖是预防糖尿病并发症的首要因素。     

老年2型糖尿病患者血清炎症因子水平及其与大血管病变的相关性

目的观察2型糖尿病患者血清炎症因子水平的变化,探讨炎症因子对2型糖尿病尤其老年患者合并心脑血管病变的影响。方法103例2型糖尿病患者按年龄及是否合并心脑血管病变分别分组。用自动生化分析仪测定所有患者血清高敏C反应蛋白（hsC-RP）、FBG、HbA1c、TC、TG、LDL-C水平,用ELISA方法测定血清白介素6（IL-6）和肿瘤坏死因子α（TNF-α）水平。结果（1）2型糖尿病患者年龄≥65岁者,血清hsC-RP、TNF-α、IL-6水平均高于年龄〈65岁者（P〈0．01）。（2）合并心脑血管病变者,血清hsC-RP水平较高于无心脑血管病变者（P〈0．05）。年龄≥65岁中合并心脑血管病变者,血清hsC-RP水平高于无心脑血管病变者（P〈0．05）。（3）血清hsC-RP水平与年龄和血清TG水平呈正相关（r=0．257,P〈0．01;r=0．220,P〈0．01）。影响hsC-RP的因素主要为年龄,回归方程为y（hsC-RP）=2．407＋0．100年龄。（4）2型糖尿病中≥65岁者合并心脑血管病变的发生率高于〈65岁者（P〈0．01）。结论hsC-RP与大血管病变相关,但IL-6和TNF-α与大血管病变无明显相关性;年龄增长是血清hsC-RP水平升高的主要影响因素。     

2型糖尿病合并冠心病与踝臂指数相关性分析

目的：探讨2型糖尿病患者合并冠心病与踝臂指数（ABI）的相关性及糖尿病并发冠心病的危险因素。方法：选择2008年1月至2008年7月在新疆医科大学第五附属医院内分泌科住院的所有糖尿病患者,共269例,男158例,女111例。按有无冠心病分为冠心病组（54例）和无冠心病组（215例）。所有患者均记录生活方式,查体质指数（BMI）、心电图,测血压、血脂、空腹血糖（FBG）、餐后2h血糖（PBG）、糖化血红蛋白（HbAlC）、C反应蛋白（CRP）。并于入院3d内行ABI测定,同时进行Logistic冠心病多因素分析。结果：（1）合并冠心病组ABI的敏感性及特异性分别为77．8％、93．5％;（2）多因素分析表明ABI降低（OR=0．421,P=0．025）、BMI≥25（OR=1．148,P=0．007）、收缩压（OR=1．035,P=0．000）、总胆固醇水平升高和颈动脉斑块是冠心病的危险因素。结论：测定ABI能提高冠心病的诊断率。     

踝臂指数与冠状动脉狭窄程度的关系

目的探讨踝臂指数与冠状动脉狭窄程度的关系。方法入选在我院住院的837例患者,其中男553例,女284例,平均年龄59.31±9.85岁.行冠造动脉造影术,以Gensini评分评价患者冠状动脉狭窄程度,检测ABI,以ABI≤0.9作为诊断外周血管病的标准。结果 ABI的高低与冠脉狭窄程度显著相关,随着ABI值的降低,Gensini评分会增加,两者呈负相关关系。同时,ABI值与动脉粥样硬化累积的冠脉支数也相关,伴有PAD冠心病患者的较外周血管正常的患者,三支病变和左主干病变所占的比例高。结论 ABI可作为冠状动脉粥样硬化的生物标记,能够反映冠状动脉狭窄程度。     

Risk Factors of Normal Ankle–Brachial Index and Low Toe–Brachial Index in Hemodialysis Patients

The prevalence of peripheral arterial occlusive disease is high in patients with terminal renal failure, and it is a major problem in those on dialysis. A low ankle–brachial index (ABI) suggests the presence of arterial stenotic lesions between the aorta and the ankle joint, while a low toe–brachial index (TBI) suggests stenotic lesions between the aorta and the toes. Therefore, a normal ABI (≥0.9) and a low TBI (<0.6) may indicate the presence of stenotic lesions located only on the peripheral side of the ankle joint. In the present study, risk factors of normal ABI/low TBI were investigated. In 115 patients on maintenance dialysis, the ABI and TBI were simultaneously measured, and the background factors and laboratory data of patients with normal ABI/low TBI (L group) and those with normal ABI/normal TBI (≥0.6) (N group) were compared. Low ankle–brachial and toe–brachial indices were detected in 13% and 22% of the patients, respectively. Comparison of the background factors and laboratory data between the N and L groups showed that the ratio of diabetes mellitus, interdialytic body weight gain, and Hb_A1c values were significantly higher in the L group than in the N group. It was clarified that diabetes and excess body weight gain are involved as risk factors in dialysis patients with normal ABI/low TBI.     

Shared and additional risk factors for decrease of toe-brachial index compared to ankle-brachial index in Japanese patients with diabetes mellitus

Objective

Some diabetic patients have a low toe-brachial index (TBI) despite their normal ankle-brachial index (ABI). We statistically investigated whether the impact of risk factors on TBI would be different compared to ABI.

Research design and methods

We used a database of 1738 limbs of consecutive 869 Japanese diabetic patients whose ABI and TBI were simultaneously evaluated. We developed a common regression model to ABI and TBI by extending the linear mixed model, and statistically detected the difference in the impact of risk factors between the two indices.

Results

Sex, smoking, proteinuria, hypertension, and history of stroke and coronary artery disease were common independent risk factors for the decrease of ABI and TBI; their impacts on ABI and TBI were not significantly different. On the other hand, the impact of age, diabetic duration, and body mass index was significantly different between the two indices (all p < 0.05). Age and body mass index were significantly associated with TBI but not with ABI. Diabetic duration had a significant impact both on TBI and ABI, but the impact on TBI was significantly greater than that on ABI (β = −0.144 vs. −0.087; p < 0.05). In the population with normal ABI, patients with these risk factors had a higher prevalence of decreased TBI.

Conclusions

The risk factors for the decrease of ABI and TBI were not identical in Japanese diabetic patients. Age, diabetic duration and body mass index were associated with reduced TBI in patients with normal ABI.     

乐亭县敬老院老年男性踝臂指数与心血管疾病危险因素的关系

目的探讨老年人踝臂指数(ABI)与心血管病危险因素之间的关系。方法采用标准化心血管病流行病学调查方法,对乐亭县4个敬老院355例60岁及以上男性人群进行调查。问卷调查包括一般情况、吸烟饮酒史、个人病史及家族史。体检包括人体测量、血压3次测量及踝臂指数(ABI)检测。ABI0.9为异常组,0.9~1.4为正常组。采集空腹静脉血测量血糖、血脂等生化指标。用SPSS软件包对ABI相关危险因素进行统计学分析。结果 ABI异常组占总人数11.3%。偏相关(控制年龄)分析显示ABI与腰围、总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)呈负相关(P均0.05)。依据心血管病常见危险因素(腰围、血压、血糖、血脂异常和吸烟)进行分析,≥3个危险因素人群比例在ABI异常组明显高于正常组(62.6%vs.37.5%,P=0.003)。多元Logistic回归分析显示,年龄(OR=1.095,95%CI:1.042~1.151)、LDL-C(OR=1.973,95%CI:1.252~3.111)、TG(OR=1.522,95%CI:1.065~2.174)、吸烟(OR=2.537,95%CI:1.205~5.339)是ABI异常的独立危险因素。结论ABI降低的人群有明显的心血管病危险因素聚集性,年龄、LDL-C、TG、吸烟是其独立危险因素。     

踝臂指数与心脑血管病危险因素关系的研究

目的探讨心脑血管病高危患者踝臂指数（ABI）异常的检出率与心脑血管疾病危险因素及临床心脑血管事件的关系。方法选取我院288例心脑血管病高危住院患者,年龄30-93（64±13）岁,男性165例,女性123例;分为ABI正常组（ABI 0．9～1．3）193例和ABI异常组（1．3〈ABI〈0．9）95例,进行ABI、身高、体重指数、腰围、臀围、血压、心率测量,病史采集及血液生化检查;比较两组间与心脑血管病各危险因素及临床心脑血管病事件发生情况的差异。结果288例患者中ABI异常95例,检出率为32．98％。影响ABI的主要危险因素为年龄（P=0．001）、性别（P=0．013）、血糖（P〈0．01）、血脂（P=0．003）、血压（P〈0．01）、吸烟（P=0．002）等。异常组心、脑血管病事件的检出率分别为26．32％和37．89％,明显高于ABI正常组的10．36％和20．21％,经Logistic回归分析处理,OR值分别是4．09、2．11,P〈0．05,差异有统计学意义。结论心脑血管病高危患者中ABI异常检出率高;ABI与心脑血管病各危险因素具有良好的相关性;ABI是心脑血管事件的预测因子之一。     

Prevalence of and risk factors for abnormal ankle-brachial index in patients with type 2 diabetes

Background: The aim of the present study was to examine abnormalities in the ankle–brachial index (ABI) and related risk factors in patients with type 2 diabetes. Methods: Between September 2003 and June 2010, the ABI was determined in 3924 outpatients attending the Diabetes Center of the People’s Liberation Army 306th Hospital. In addition, demographic and laboratory data were collected. The risk factors for an abnormal ABI were determined using univariate and stepwise logistic regression analysis. Results: The ABI was normal (0.91–1.3) in 93.1% of patients, low (<0.9) in 5.2%, and high (>1.3) in 1.7%. The prevalence of abnormal lower ABI was greater in elderly (≥ 65 years) patients (12.2%) than in younger (< 65 years) patients (3.6%). Using normal ABI as the reference, low ABI in younger patients was found to be independently associated with HbA1c, the urinary albumin:creatinine ratio, diabetic peripheral neuropathy, diabetic retinopathy, and cerebrovascular disease. A low ABI in elderly patients was found to be independently associated with age, smoking, HbA1c, uric acid, total cholesterol, diabetic peripheral neuropathy, diabetic retinopathy, diabetic nephropathy and cerebrovascular disease. A high ABI in younger patients was associated with being male. Conclusions: The prevalence of an abnormal ABI was high in patients with type 2 diabetes, especially elderly patients. Early identification and intensive treatment are needed to improve the quality of life and overall prognosis of patients with type 2 diabetes.     

踝臂指数与动脉硬化及其危险因素的关系

目的了解踝臂指数与动脉硬化及其危险因素的关系。方法对174例住院患者行选择性冠状动脉造影,用冠状动脉病变血管的数量和Gensini积分系统评价冠状动脉病变的严重程度。并进行踝臂指数测定、眼底动脉检查及动脉硬化的危险因素分析。结果冠状动脉正常组与冠状动脉病变组踝臂指数差异显著(P<0.001),冠状动脉造影积分和踝臂指数的Pearson积距相关系数为-0.768(P<0.001),冠状动脉造影积分越高,踝臂指数越低。眼底动脉正常组与眼底动脉病变组踝臂指数差异显著(P<0.001),眼底动脉病变越严重踝臂指数越小。眼底动脉正常组与眼底动脉病变组冠状动脉造影积分差异显著(P<0.001),眼底动脉病变越严重冠状动脉造影积分越高。以踝臂指数<0.9为二分类变量做Logistic回归分析,发现踝臂指数与年龄、性别、甘油三酯、低密度脂蛋白、吸烟量、糖尿病和遗传因素相关。结论踝臂指数是动脉硬化的一个简便可靠的预测因素,低踝臂指数与传统的动脉硬化危险因素如年龄、性别、甘油三酯、低密度脂蛋白、吸烟量、糖尿病和遗传因素有相关性。     

The long-term prognostic value of the resting and postexercise ankle-brachial index

BACKGROUND: Peripheral arterial disease is associated with a high incidence of cardiovascular mortality. Peripheral arterial disease can be detected by using the ankle-brachial index (ABI). This study assessed the prognostic value of the postexercise ABI in addition to the resting ABI on long-term mortality in patients with suspected peripheral arterial disease. METHODS: In this prospective cohort study of 3209 patients (mean +/- SD age, 63 +/- 12 years; 71.1% male), resting and postexercise ABI values were measured and a reduction of postexercise ABI over baseline resting readings was calculated. The mean follow-up was 8 years (interquartile range, 4-11 years). RESULTS: During follow-up, 1321 patients (41.2%) died. After adjusting for clinical risk factors, lower resting ABI values (hazard ratio per 0.10 lower ABI, 1.08; 95% confidence interval [CI], 1.06-1.10), lower postexercise ABI values (hazard ratio per 0.10 lower ABI, 1.09; 95% CI, 1.08-1.11), and higher reductions of ABI values over baseline readings (hazard ratio per 10% lower ABI, 1.12; 95% CI, 1.09-1.14) were significantly associated with a higher incidence of mortality. In patients with a normal resting ABI (n = 789), a reduction of the postexercise ABI by 6% to 24%, 25% to 55%, and greater than 55% was associated with a 1.6-fold (95% CI, 1.2-2.2), 3.5-fold (95% CI, 2.4-5.0), and 4.8-fold (95% CI, 2.5-9.1) increased risk of mortality, respectively. CONCLUSIONS: Resting and postexercise ABI values are strong and independent predictors of mortality. A reduction of postexercise ABI over baseline readings can identify additional patients (who have normal ABI values at rest) at increased risk of subsequent mortality.     

Prognostic value of a low post-exercise ankle brachial index as assessed by primary care physicians

ObjectiveWe aimed to investigate whether the post-exercise ankle brachial index (ABI) performed by primary care physicians offers useful information for the prediction of death or cardiovascular events, beyond the traditional resting ABI. An additional focus was on patients with intermittent claudication and normal resting ABI.MethodsUsing data from the 5-year follow-up of 6468 elderly patients in the primary care setting in Germany (getABI study) we used multivariate Cox regression models adjusted for age, gender and conventional risk factors to determine the association of resting ABI and/or post-exercise ABI and all-cause mortality/morbidity.ResultsMean post-exercise ABI in the total cohort was 0.977 and resting ABI was 1.034. For post-exercise ABI, a threshold value of 0.825 had nearly the same sensitivity (28.6%) and specificity (85.7%) as the conventionally used resting ABI with a cut-off value of 0.9 to predict death. Compared to patients with normal post-exercise ABI, a low post-exercise ABI was associated with an almost identical risk increase for mortality (hazard ratio [HR] 1.56, 95% confidence interval [CI] 1.30–1.86) as a low resting ABI (HR 1.65; CI 1.39–1.97) and/or myocardial infarction/stroke. Slight differences were observed for coronary/carotid revascularisation and peripheral revascularisation/amputation. In combined models it could not be shown that post-exercise ABI yielded relevant additional information for the prognosis of mortality and/or myocardial infarction/stroke, not even in the subgroup analysis of patients with intermittent claudication and normal resting ABI.ConclusionsIt could not be shown that the post-exercise ABI is a useful tool for the prognosis of mortality and/or myocardial infarction/stroke beyond the resting ABI.     

Swiss Atherothrombosis Survey: a field report on the occurrence of symptomatic and asymptomatic peripheral arterial disease

OBJECTIVES: To investigate the Ankle/Brachial Pressure Index (ABI) for its suitability in daily practice to identify patients at atherothrombotic risk. To collect data on the prevalence of atherothrombotic events [coronary artery disease (CAD), stroke/transient ischaemic attack (TIA)], of 'hidden' (asymptomatic) versus 'known' (symptomatic) peripheral arterial disease (PAD) and treatment in the general practice population. DESIGN: Field survey from everyday Swiss practice. On five consecutive workdays, 276 doctors documented all patients, recording gender, age, history of atherothrombotic events, risk factors and family history. In the case of a previous stroke/TIA and/or CAD, or two or more risk factors were present at age >55, the ABI was determined. A total of 25,351 patients were included and 3921 ABI measurements were performed in eligible patients. SETTING: Practices of primary care doctors. PARTICIPANTS: All patients who visited one of the 276 participating doctors on one of five consecutive workdays were included in the survey. INTERVENTION: Data recording and measurement of the ABI on those patients who qualified. RESULTS: Of the patients 3.7% had symptomatic PAD. An additional 2.7% of hitherto asymptomatic patients were identified as being at high atherothrombotic risk by having an ABI value <0.9. Exactly 93.9% of the participating doctors considered the ABI measurement easy to incorporate into the diagnostic routine of patients presenting with risk factors. CONCLUSIONS: The ABI measurement is an easy-to-use, noninvasive and reliable means to identify patients at risk of atherothrombotic events. Identification of asymptomatic PAD leads to intensified targeted prophylactic atherothrombotic treatment that can reduce morbidity and mortality.