Arterial stiffness and microvascular disease in type 2 diabetes

Abstract

Background The clustering of arterial stiffness with microvascular disease (MD) and their effects on the clinical outcome of patients with type 2 diabetes (T2D) remains not fully clarified. Methods In a prospective study of 414 patients with T2D, we investigated the prognostic value of arterial stiffness and MD for clinical outcomes. Participants were assessed for the presence of MD (ie diabetic retinopathy, nephropathy and neuropathy) and arterial stiffness by pulse wave velocity (PWV) and followed‐up for a median of 30 (range 1‐60) months. The primary endpoint of the study was the composite endpoint of major adverse cardiovascular events, that is, cardiovascular and non‐cardiovascular mortality and non‐fatal myocardial infarction/stroke. Results A total of 146 (35.3%) patients had evidence of MD at baseline. In cox regression models, MD and PWV were independently associated with the composite clinical endpoint; for MD hazard ratio (HR), 3.24, 95%CI, 1.10‐9.54, P=.032, and for PWV HR, 1.20, 95%CI, 1.06‐1.36, P=.004) after adjustment for traditional risk factors, and enhanced risk discrimination and reclassification. The subgroup of patients with MD and high PWV was associated with increased incidence of the composite clinical endpoint (20.9% vs 1.8% in those with no MD & low PWV, P=.001). Importantly, absence of MD at baseline was associated with no mortality events during the follow‐up period. PWV at baseline was not associated with MD progression during follow‐up. Conclusions These findings support that screening for arterial stiffness and MD in the routine clinical assessment of patients with T2D may enhance prognostication and cardiovascular risk reclassification.

Impact of diabetic retinopathy on pulse wave analysis-derived arterial stiffness and hemodynamic parameters: A cross-sectional study from Gujarat, India

“…First, the AS-DR relationship is strongest with PDR type,[ 11 13 ] which was prevalent lesser than NPDR in the study. Second, we did not have baseline data as reported recently[ 21 ] that baseline PWV is not associated with microvascular dysfunction. The same could have happened in our participants as diagnosis of type 2 diabetes is late.…”

Ginsenoside Rg1 interferes with the progression of diabetic osteoporosis by promoting type H angiogenesis modulating vasculogenic and osteogenic coupling

“…Angiogenesis is a prerequisite for the healing of skeletal conditions such as fractures and defects ( Maes, 2013 ; Ramasamy et al, 2016b ). Vascular injury is a major contributor to many organ dysfunctions caused by diabetes, which are referred to as diabetic vascular complications ( Beckman and Creager, 2016 ; Antonopoulos et al, 2021 ). Previous studies on diabetic bone vessels have focused on the relationship between vascular injury and abnormal hematopoiesis in the bone marrow, and little attention has been given to the potential association between the bone vascular system and bone mass lesions ( Fajardo, 2017 ; Shanbhogue et al, 2017 ).…”

Increased Arterial Stiffness as a Predictor for Onset and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus

“…The discrepancy may be attributable to the race difference and stricter exclusion criteria in the present study, specifically with acute coronary syndrome, cerebrovascular disease, and peripheral arterial disease, which might influence the measurement of AS. Subgroup analysis from another study investigating the clustering of AS and microvascular complications of T2DM and their effects on the composite clinical endpoints found that PWV was correlated with neither the presence of microvascular complications at baseline nor its deterioration at follow-up [37]. The study defined microvascular complications as the presence of DR, diabetic kidney disease, and diabetic neuropathy or diabetic foot.…”