Arterial Stiffness and HbA1c: Association Mediated by Insulin Resistance in Hispanic Adults

Martagón, Alexandro J.; Antonio-Villa, Neftalí Eduardo; Mehta, Roopa; Almeda‐Valdés, Paloma; Vargas‐Vázquez, Arsenio; Muñóz-Hernández, Liliana; Gómez‐Velasco, Donají; Elías-López, Daniel; Galán-Ramírez, Gabriela A.; Razo-Olvera, Fabiola Mabel Del; Cruz-Bautista, Ivette; González-Arellanes, Rogelio; Aguilar-Salinas, Carlos

doi:10.3390/ijerph191711017

Cited by 5 publications

(3 citation statements)

References 28 publications

(33 reference statements)

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“…Moreover, several studies concluded that HbA1c was related to PWV independent of conventional cardiovascular risk factors such as age and blood pressure, a finding that was in line with our results 35,36 . Various mechanisms have been proposed to link HbA1c with the development of atherosclerosis, including through insulin resistance due to endothelial dysfunction and an abnormal insulin vasodilative effect mediated by endothelium‐derived nitric oxide 37 . All these alterations may contribute to the development and progression of atherosclerosis.…”

Section: Discussionsupporting

confidence: 91%

“…35,36 Various mechanisms have been proposed to link HbA1c with the development of atherosclerosis, including through insulin resistance due to endothelial dysfunction and an abnormal insulin vasodilative effect mediated by endothelium-derived nitric oxide. 37 All these alterations may contribute to the development and progression of atherosclerosis. Future studies are needed to investigate T A B L E 3 Hazard ratios (95% CI) of the association between cfPWV, faPWV, and afSG and all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

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Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population‐based study

Liang

Zhou

Chen

et al. 2023

Journal of Diabetes

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BackgroundArterial stiffness contributes to additional cardiovascular risks in diabetic patients by triggering the loss of vascular and myocardial compliance and promoting endothelial dysfunction. Thus, prevention of arterial stiffness is a public health priority, and the identification of potential biomarkers may provide benefits for early prevention. This study investigates the relationships between serum laboratory tests and pulse wave velocity (PWV) tests. We also investigated the associations between PWV and all‐cause mortality.MethodsWe examined a panel of 33 blood biomarkers among diabetic populations in the Atherosclerosis Risk in Communities Study. The carotid‐femoral (cfPWV) and femoral‐ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The aortic‐femoral arterial stiffness gradient (afSG) was calculated as faPWV divided by cfPWV. Biomarker levels were log‐transformed and correlated with PWV. Cox proportional hazard models were employed for survival analysis.ResultsAmong 1079 diabetic patients, biomarkers including high‐density lipoprotein cholesterol, glycated hemoglobin, high‐sensitivity troponin T, cystatin C, creatinine, and albuminuria were significantly correlated with afSG (R = 0.078, −0.193, −0.155, −0.153, −0.116, and −0.137, respectively) and cfPWV (R = −0.068, 0.175, 0.128, 0.066, 0.202, and 0.062, respectively). Compared with the lowest tertile of afSG, the risk of all‐cause mortality was lower in the highest tertile (hazard ratio 0.543; 95% confidence interval 0.328–0.900).ConclusionCertain biomarkers related to blood glucose monitoring, myocardial injury, and renal function significantly correlated with PWV, suggesting that these putative risk factors are likely to be important atherosclerosis mechanisms in diabetic patients. AfSG may be an independent predictor of mortality among diabetic populations.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population‐based study

Liang

Zhou

Chen

et al. 2023

Journal of Diabetes

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“…The association between HbA1c, an indicator of long-term blood glucose regulation, and aortic stiffness seems to be constrained in certain studies [41][42][43].…”

Section: Correlations Between Aortic Elasticity Indices and Diabetic ...mentioning

confidence: 99%

Alterations in Aortic Elasticity Indices among Type 2 Diabetes Patients in a Low and Middle Income Country Using M-Mode Echocardiography: A Cross-Sectional Comparative Study

Dang,

Luong,

Nguyen Khoi

et al. 2024

Preprint

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BackgroundDiabetes is one of the leading causes of noncommunicable diseases worldwide. It is known to induce cardiovascular remodeling, which can result in a variety of complications, including a considerable increase in aortic stiffness. While studies in Western populations have explored these effects, data on Asians, particularly Vietnamese, are limited. This study aimed to assess aortic elasticity in type 2 diabetes mellitus (T2DM) patients compared to healthy individuals.MethodsAortic elasticity indices were measured using M-mode echocardiography. A comparison between the healthy group and the T2DM group revealed substantial differences in aortic elasticity indices.ResultsThe aortic stiffness index (ASI) was significantly greater in the T2DM group than in the control group, with median values of 6.10 (3.64-12.47) and 3.79 (2.40-8.50), respectively (p = 0.003). Aortic strain (AS) was substantially lower in the T2DM group than in the control group, with median values of 8.21 (4.24 - 13.07) and 10.66 (6.01 - 18.23), respectively (p = 0.039). Furthermore, the median aortic compliance (AC) and aortic distensibility (AD) in individuals with T2DM were 4.07 (2.28-7.44) and 3.08 (1.57-5.26), respectively, lower than those in the control group, with median values of 6.40 (3.08-10.75) and 5.33 (2.80-9.79), respectively. A longer diabetes duration was linked to a greater ASI (r = 0.43, p < 0.05), while the AS decreased (r = -0.37, p < 0.05).ConclusionsSubstantial variations in aorta elasticity indices were found using M-mode echocardiography. More research is needed to investigate the consequences of these discrepancies and their significance for clinical purposes.Graphical Abstract

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Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes

Fang

Shi

Zhang

et al. 2023

Cardiovasc Diabetol

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Background Glycemic variability plays an important role in the development of cardiovascular disease (CVD). This study aims to determine whether long-term visit-to-visit glycemic variability is associated with aortic stiffness progression in participants with type 2 diabetes (T2D). Methods Prospective data were obtained from 2115 T2D participants in the National Metabolic Management Center (MMC) from June 2017 to December 2022. Two brachial-ankle pulse wave velocity (ba-PWV) measurements were performed to assess aortic stiffness over a mean follow-up period of 2.6 years. A multivariate latent class growth mixed model was applied to identify trajectories of blood glucose. Logistic regression models were used to determine the odds ratio (OR) for aortic stiffness associated with glycemic variability evaluated by the coefficient of variation (CV), variability independent of the mean (VIM), average real variability (ARV), and successive variation (SV) of blood glucose. Results Four distinct trajectories of glycated hemoglobin (HbA1c) or fasting blood glucose (FBG) were identified. In the U-shape class of HbA1c and FBG, the adjusted ORs were 2.17 and 1.21 for having increased/persistently high ba-PWV, respectively. Additionally, HbA1c variability (CV, VIM, SV) was significantly associated with aortic stiffness progression, with ORs ranging from 1.20 to 1.24. Cross-tabulation analysis indicated that the third tertile of the HbA1c mean and VIM conferred a 78% (95% confidence interval [CI] 1.23–2.58) higher odds of aortic stiffness progression. Sensitivity analysis demonstrated that the SD of HbA1c and the highest HbA1c variability score (HVS) were significantly associated with the adverse outcomes independent of the mean of HbA1c during the follow-up. Conclusions Long-term visit-to-visit HbA1c variability was independently associated with aortic stiffness progression, suggesting that HbA1c variability was a strong predictor of subclinical atherosclerosis in T2D participants.

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Arterial Stiffness and HbA1c: Association Mediated by Insulin Resistance in Hispanic Adults

Cited by 5 publications

References 28 publications

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population‐based study

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population‐based study

Alterations in Aortic Elasticity Indices among Type 2 Diabetes Patients in a Low and Middle Income Country Using M-Mode Echocardiography: A Cross-Sectional Comparative Study

Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes

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