Arterial Stiffness and Peripheral Arterial Status in Patients with Diabetic Foot Ulcers: A Cross-sectional Comparative Study

Abstract Diabetic foot ulcer (DFU) is associated with substantial vascular morbidity, but the relationship between DFU, central arterial stiffness, and peripheral arterial impairment remains incompletely defined. This study compared central pulse wave velocity (cPWV) and ankle–brachial index (ABI) between patients with DFU and non-diabetic clinic controls. This cross-sectional comparative study included 72 participants: 36 patients with type 2 diabetes mellitus and Wagner grade 1 or 2 DFU and 36 non-diabetic clinic controls. Central PWV and ABI were measured automatically using the AngE Pro 4 system. Between-group comparisons, categorical analyses using cPWV > 8 m/s and ABI < 0.90, and Pearson's correlation analyses were performed using SPSS version 22. Mean cPWV did not differ significantly between the DFU and control groups (7.758 ± 2.016 vs. 7.456 ± 2.816 m/s; p = 0.602). Mean ABI did not differ significantly between groups (1.056 ± 0.334 vs. 1.109 ± 0.290; p = 0.475). Elevated cPWV (> 8 m/s) was observed in 30.6% of patients with DFU and 25.0% of controls (p = 0.601). ABI < 0.90 was more frequent in the DFU group (36.1% vs. 19.4%; OR = 2.342, 95% CI: 0.804–6.823), although the difference was not statistically significant (p = 0.117). Central PWV showed a weak positive correlation with systolic blood pressure (r = 0.247, p = 0.037). Patients with Wagner grade 1 or 2 DFU did not demonstrate significantly greater central arterial stiffness or lower mean ABI than non-diabetic clinic controls. However, abnormal ABI was numerically more frequent in the DFU group. Larger prospective studies are needed to clarify the vascular significance of cPWV and ABI in diabetic foot disease.