Diminished arterial elasticity in diabetes: association with fluorescent advanced glycosylation end products in collagen

Airaksinen, Juhani; Salmela, Pasi; Linnaluoto, Markku K.; Ikäheimo, Markku J.; Ahola, Kari; Ryhänen, Lasse

doi:10.1093/cvr/27.6.942

Cited by 165 publications

(110 citation statements)

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“…20) Many of these processes inhibit endothelial nitric oxide synthase, which consequently impairs peripheral endothelial function and adversely affects vascular stiffness. 20,24) We also showed pre-DM subjects had a signifi cantly higher HOMA index than non-DM patients and insulin resistance was an important factor in the stiffening of arteries. 25,26) HOMA index may refl ect pro-infl ammatory signals and increase systemic infl ammation induced by visceral fat that alter insulin function and possibly the structural integrity of the vascular wall.…”

Section: Possible Mechanisms Of Increased Arterial Stiffness In Pre-dmmentioning

confidence: 71%

Effects of Deranged Glucose Homeostasis on Peripheral Arterial Stiffness Index in Patients With Pre-Diabetes Mellitus

et al. 2013

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SummaryPremature arteriosclerosis may be one of the mechanisms linking pre-diabetes mellitus (pre-DM) and cardiovascular disease. We sought to characterize premature arteriosclerosis in pre-DM using different arterial stiffness indices and to fi nd the independent contributors of this process. We recruited 33 patients without DM, 53 patients with pre-DM, and 34 subjects with DM. Both the compliance index (CI) and stiffness index (SI) were measured. Patients with pre-DM and DM had lower CI (3.8 ± 2.1 versus 5.2 ± 3.0 units; P < 0.05 and 3.6 ± 1.8 versus 5.2 ± 3.0 units; P < 0.05, respectively) and higher SI (8.0 ± 2.0 versus 6.7 ± 1.6 m/s; P < 0.01 and 9.4 ± 2.3 versus 6.7 ± 1.6 m/s; P < 0.001, respectively) than patients without DM. Using multivariate linear regression analysis, age, heart rate, and HOMA index were independent determinants for SI (whole model: R 2 = 0.47, P < 0.001), whereas male gender, hsCRP, and HOMA index were independent determinants for CI (whole model: R 2 = 0.34, P < 0.01). The HOMA index was an independent determinant for arterial stiffness. Increased insulin resistance may associate with increased arterial stiffness at peripheral arteries in pre-DM patients. (Int Heart J 2013; 54: 27-32)

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Section: Possible Mechanisms Of Increased Arterial Stiffness In Pre-dmmentioning

confidence: 71%

Effects of Deranged Glucose Homeostasis on Peripheral Arterial Stiffness Index in Patients With Pre-Diabetes Mellitus

et al. 2013

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“…It is also plausible that insulin resistance syndromes are characterised by abnormalities in the physiological properties of insulin, which normally preserve arterial wave reflections and central haemodynamics [24]. In this population, 2-HPG and HOMA-IR may reflect pro-inflammatory signals induced by visceral fat that alter insulin function and possibly the structural integrity of the vascular wall [40]. We did not attempt to quantify the relative contribution of wave reflections to elevated cf PWV, although we recognise that this may be an important determinant of central haemodynamic dysfunction in insulin-resistant states.…”

Section: Resultsmentioning

confidence: 99%

Impact of metabolic indices on central artery stiffness: independent association of insulin resistance and glucose with aortic pulse wave velocity

et al. 2010

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Aims/hypothesis Non-invasive measures of aortic stiffness reflect vascular senescence and predict outcome in diabetes. Glucose-mediated elastic artery sclerosis may play an integral role in the development of macrovascular complications. We used carotid-femoral pulse wave velocity ( cf PWV) to quantify independent associations of fasting glucose, post-challenge glucose and derived insulin resistance (HOMA-IR) with aortic stiffness. Methods cf PWV was measured using a 4 MHz continuous wave Doppler ultrasound probe within groups with newly identified age-and sex-matched normal glucose metabolism (NGM), impaired glucose regulation (IGR) and diabetes mellitus populations (n=570, mean age 59.1, 56% male). Results After multivariate adjustment, IGR and diabetes were associated with significant aortic stiffening compared with NGM (adjusted cf PWV±SE: NGM, 9.15±0.12 m/s; IGR 9.76±0.11 m/s, p<0.001; diabetes, 9.89±0.12 m/s, p< 0.001). IGR stratification indicated that impaired fasting glucose (IFG; 9.71±0.12 m/s) and post-challenge (impaired glucose tolerance; 9.82±0.24 m/s) categories had similar cf PWV (p=0.83). Modelled predictors of cf PWV were used to assess independent metabolic associations with arterial stiffness. Fasting glucose concentration (β=0.10; 95% CI 0.05, 0.18; p=0.003), 2 h post-challenge glucose (β=0.14; 95% CI 0.02, 0.23; p<0.001) and HOMA-IR (β=0.20, 95% CI 0.05, 0.53; p<0.001) were independently related to cf PWV after adjustment for age, sex, mean arterial pressure, heart rate, body mass index, renal function and antihypertensive medication. Conclusions/interpretation IGR characterised by fasting or post-challenge hyperglycaemia is associated with significant vascular stiffening. Post-challenge glucose and HOMA-IR are the most powerful metabolic predictors of arterial stiffness, implying hyperglycaemic excursion and insulin resistance play important roles in the pathogenesis of arteriosclerosis.

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“…The reduced arterial elasticity may be the consequence of hyperglycemia's and/or insulin's acting either directly or through the development of advanced glycation end products. Nonenzymatic glycosylation of the matrix proteins of arterial vessels may enhance the production of cross-links between collagen fibers, which in turn are responsible for increased arterial stiffness and systolic hypertension (37). In rodent and human, the increased number of collagen cross-links may be reversed after administration of specific collagen cross-linking breakers (38,39).…”

mentioning

confidence: 99%

Obesity, Arterial Stiffness, and Cardiovascular Risk

Safar

Czernichow²,

Blacher³

2006

Journal of the American Society of Nephrology

168

133

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Long-term follow-up studies have indicated that obesity is an independent predictor of cardiovascular risk in both genders. Increased arterial stiffness, as reflected by an increased pulse wave velocity, is significantly and independently associated with higher risk for cardiovascular morbidity and mortality. In recent years, it has been demonstrated that individuals with obesity are likely to have an increase in aortic stiffness, independent of BP level, ethnicity, and age. The pathophysiologic mechanisms that link abdominal adiposity to stiffening are not fully understood. This report focuses on the role of arterial stiffness in individuals with obesity and on the association between this hemodynamic feature and cardiovascular risk.

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Diminished arterial elasticity in diabetes: association with fluorescent advanced glycosylation end products in collagen

Abstract: These data suggest that non-enzymatic glycosylation of matrix proteins, and specifically collagen, may modify arterial elasticity in diabetic patients with coronary artery disease.

Cited by 165 publications

References 0 publications

Effects of Deranged Glucose Homeostasis on Peripheral Arterial Stiffness Index in Patients With Pre-Diabetes Mellitus

Effects of Deranged Glucose Homeostasis on Peripheral Arterial Stiffness Index in Patients With Pre-Diabetes Mellitus

Impact of metabolic indices on central artery stiffness: independent association of insulin resistance and glucose with aortic pulse wave velocity

Obesity, Arterial Stiffness, and Cardiovascular Risk

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