Metabolic parameters associated with arterial stiffness in older adults with Type 2 diabetes

Teoh, Wei Leng; Price, Jackie F.; Williamson, R.; Payne, Rupert; Look, Liesbeth A.F. Van; Reynolds, Rebecca M.; Frier, Brian M.; Wilkinson, Ian B.; Webb, David J.; Strachan, Mark W. J.; Investigators, Et Ds

doi:10.1097/hjh.0b013e32835f7ecf

Cited by 48 publications

(54 citation statements)

References 40 publications

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“…Interestingly, inflammatory markers were associated to PWV but not to IMT. A recent study performed in Edinburgh in a similar setting reported that inflammatory markers were not at all correlated to PWV (17) .…”

Section: Discussionmentioning

confidence: 91%

Abdominal obesity and low-grade systemic inflammation as markers of subclinical organ damage in type 2 diabetes

Dahlén

Tengblad

Länne

et al. 2014

Diabetes & Metabolism

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SummaryAim:The aim of this study was to explore associations between abdominal obesity, inflammatory markers, and subclinical organ damage in 740 patients with type 2 diabetes. Methods:Waist circumference (WC) and sagittal abdominal diameter (SAD) was measured. Blood samples were analyzed for; C-reactive protein (CRP) and IL-6. Carotid intima-media thickness (IMT) was evaluated by ultrasonography. Aortic pulse wave velocity (PWV) was measured with applanation tonometry. Results:Abdominal obesity measured as SAD and WC were significantly correlated with; IL-6 (WC r=0.27, p<0.001, SAD r=031, p<0.001 ), CRP (WC r=0,29, p <0.001, SAD r=0,29, p <0.001), IMT (WC r=0.09 p=0.013, SAD r=0.11, p=0.003) and PWV (WC r=0.18, p<0.001, SAD r=0.21, p <0.001). In multiple linear regressions with IMT or PWV as dependent variable and age, sex, statins, systolic blood pressure (SBP), Body Mass Index (BMI), CRP and HbA1c, as independent variables, both SAD and WC, remained associated with IMT and PWV. In stepwise linear regression, entering both SAD and WC, the association between SAD and PWV was stronger than the association between WC and PWV. Conclusion:We conclude that SAD and WC are feasible measures of obesity that provides information on inflammation, atherosclerosis and arterial stiffness in type 2 diabetes. However, SAD was slightly more robustly associated to subclinical organ damage, compared with WC.

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Section: Discussionmentioning

confidence: 91%

Abdominal obesity and low-grade systemic inflammation as markers of subclinical organ damage in type 2 diabetes

Dahlén

Tengblad

Länne

et al. 2014

Diabetes & Metabolism

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“…10,25 Indices of central obesity including WC and WHtR consistently present higher level of correlation with PWV than BMI, a measure of general obesity, in healthy, diabetic and hypertensive subjects. 10 Similarly in our work, we observed a better correlation between measures of central obesity (WC and VFA) rather than general obesity (BMI and BAI) and PWV.…”

Section: Discussionmentioning

confidence: 95%

Evaluation of body adiposity index as a predictor of aortic stiffness in multi-ethnic Asian population with type 2 diabetes

Moh

Sum

Lam

et al. 2014

Diabetes and Vascular Disease Research

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Cardiovascular disease is the leading cause of morbidity and mortality in type 2 diabetes mellitus. We evaluated the predictive ability of the recently developed body adiposity index for aortic stiffness, an intermediate endpoint of cardiovascular disease, in a cross-sectional multi-ethnic Asian type 2 diabetes mellitus cohort (N = 1408). AS was estimated using carotid-femoral pulse wave velocity measured by applanation tonometry. Body adiposity index was computed as hip circumference/(height)(1.5) - 18. Compared to body mass index, waist circumference and visceral fat area, body adiposity index displayed the weakest association with pulse wave velocity (r = 0.077, 0.096, 0.134 and 0.058, respectively; all p < 0.05). Interestingly, the relationship between measurements of obesity and pulse wave velocity was ethnic dependent - body mass index, body adiposity index, waist circumference and visceral fat area consistently predicted pulse wave velocity only in Indians but not others. In multi-variable analysis, body mass index was a significant determinant of pulse wave velocity in all ethnicities. In conclusion, body adiposity index is a weak predictor of aortic stiffness (when compared with body mass index) in Asians with type 2 diabetes mellitus.

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“…Whether reducing aortic stiffness will be associated with a better prognosis in patients with type 2 diabetes still needs to be demonstrated in future multiple-intervention prospective investigations. Some previous cross-sectional studies (29,30) have suggested that aortic stiffness might be associated with HbA 1c levels; notably, in this study it was possible to establish temporality, so we can speculate that there is causality between HbA 1c levels and aortic stiffness progression/regression, which may be in part mediated by advanced glycation Heart rate at 1st cf-PWV ( Candidate variables to enter the model: age, sex, baseline BMI, change in weight during follow-up, diabetes duration, physical activity, smoking status, dyslipidemia, insulin, statin and aspirin use, arterial hypertension, number of antihypertensive drugs in use, each macro-and microvascular diabetes complication, mean HbA 1c between 1st and 2nd cf-PWV, baseline glomerular filtration rate, SBP and heart rate at 1st cf-PWV measurement and relative changes in SBP and heart rate between 1st and 2nd cf-PWV, and 1st cf-PWV measurement. Table 2, except mean HbA 1c between 1st and 2nd cf-PWV that was categorized at $7.5% (58 mmol/mol).…”

Section: Discussionmentioning

confidence: 99%

Correlates of Aortic Stiffness Progression in Patients With Type 2 Diabetes: Importance of Glycemic Control

et al. 2015

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OBJECTIVEThe correlates of serial changes in aortic stiffness in patients with diabetes have never been investigated. We aimed to examine the importance of glycemic control on progression/regression of carotid-femoral pulse wave velocity (cf-PWV) in type 2 diabetes. RESEARCH DESIGN AND METHODSIn a prospective study, two cf-PWV measurements were performed with the Complior equipment in 417 patients with type 2 diabetes over a mean followup of 4.2 years. Clinical laboratory data were obtained at baseline and throughout follow-up. Multivariable linear/logistic regressions assessed the independent correlates of changes in cf-PWV. RESULTSMedian cf-PWV increase was 0.11 m/s per year (1.1% per year). Overall, 212 patients (51%) increased/persisted with high cf-PWV, while 205 (49%) reduced/persisted with low cf-PWV. Multivariate linear regression demonstrated direct associations between cf-PWV changes and mean HbA 1c during follow-up (partial correlation 0.14, P = 0.005). On logistic regression, a mean HbA 1c ‡7.5% (58 mmol/mol) was associated with twofold higher odds of having increased/persistently high cf-PWV during follow-up. Furthermore, the rate of HbA 1c reduction relative to baseline levels was inversely associated with cf-PWV changes (partial correlation 20.11, P = 0.011) and associated with reduced risk of having increased/persistently high aortic stiffness (odds ratio 0.82 [95% CI 0.69-0.96]; P = 0.017). Other independent correlates of progression in aortic stiffness were increases in systolic blood pressure and heart rate between the two cf-PWV measurements, older age, female sex, and presence of dyslipidemia and retinopathy. CONCLUSIONSBetter glycemic control, together with reductions in blood pressure and heart rate, was the most important correlate to attenuate/prevent progression of aortic stiffness in patients with type 2 diabetes.

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Metabolic parameters associated with arterial stiffness in older adults with Type 2 diabetes

Abstract: Central obesity in people with Type 2 diabetes was associated with increased arterial stiffness. This association was independent of the conventional factors associated with central obesity and further studies are required to identify the mechanisms involved.

Cited by 48 publications

References 40 publications

Abdominal obesity and low-grade systemic inflammation as markers of subclinical organ damage in type 2 diabetes

Abdominal obesity and low-grade systemic inflammation as markers of subclinical organ damage in type 2 diabetes

Evaluation of body adiposity index as a predictor of aortic stiffness in multi-ethnic Asian population with type 2 diabetes

Correlates of Aortic Stiffness Progression in Patients With Type 2 Diabetes: Importance of Glycemic Control

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