Arterial wall stiffness is associated with peripheral circulation in patients with type 2 diabetes

Kizu, Akane; Koyama, Hideki; Tanaka, Shinji; Maeno, Takaaki; Komatsu, Miyoko; Fukumoto, Shinya; Emoto, Masanori; Shoji, Tetsuo; Inaba, Masaaki; Shioi, Atsushi; Miki, Takami; Nishizawà, Yoshiki

doi:10.1016/s0021-9150(03)00237-5

Cited by 48 publications

(32 citation statements)

References 31 publications

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“…Although only aortic and carotid stiffness have shown to be of predictive value for CVD in CKD populations (27), data on FA stiffness are also of potential clinical importance. At least in patients with type 2 diabetes, FA stiffness is a predictor of peripheral vascular disease (53,54). To the best of our knowledge, no data exist on the relation between FA stiffness and peripheral vascular disease in patients with CKD.…”

Section: Discussionmentioning

confidence: 99%

Estimated Glomerular Filtration Rate and Urinary Albumin Excretion Are Independently Associated with Greater Arterial Stiffness

Hermans¹,

Henry²,

Dekker³

et al. 2007

Journal of the American Society of Nephrology

189

123

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Mild renal insufficiency is a risk factor for cardiovascular disease (CVD). Both a decline in GFR and/kPa) of the carotid artery. After adjustment for age, MAP, gender, and GTS, a greater UACR (per quartile) was in addition associated with a shorter carotid-femoral transit time (؊1.67 ms; 95% CI ؊3.24 to ؊0.10 ms). These associations were not substantially changed by mutual adjustment for eGFR and UACR. In individuals with mild renal insufficiency, both a lower eGFR and a greater albumin excretion, even below levels that are considered to reflect microalbuminuria, are independently associated with greater arterial stiffness. Moreover, these associations were mutually independent. These findings may explain, in part, why eGFR and microalbuminuria are associated with greater risk for CVD and suggest that amelioration of arterial stiffness could be a target of intervention.

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Section: Discussionmentioning

confidence: 99%

Estimated Glomerular Filtration Rate and Urinary Albumin Excretion Are Independently Associated with Greater Arterial Stiffness

Hermans¹,

Henry²,

Dekker³

et al. 2007

Journal of the American Society of Nephrology

189

123

View full text Add to dashboard Cite

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“…39,42 Our data would then support the hypothesis that the process of arterial remodelling may favour the preservation of (elastic) compliance, 43 which is in accordance with our observation that the carotid and brachial arterial diameter were significantly increased in the MetS (Table 4). Nevertheless, peripheral arterial stiffness may be clinically just as important as it has been shown to be closely associated with prevalent peripheral vascular disease, 44,45 which is a clinically important outcome in the (pre-) diabetic population. Future research will clarify this issue.…”

Section: Discussionmentioning

confidence: 99%

The metabolic syndrome in elderly individuals is associated with greater muscular, but not elastic arterial stiffness, independent of low-grade inflammation, endothelial dysfunction or insulin resistance—The Hoorn Study

et al. 2009

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The metabolic syndrome (MetS) increases cardiovascular disease (CVD) risk. How MetS increases CVD risk is incompletely understood, but increasing arterial stiffness is one candidate link, which in turn could be explained by (low-grade) inflammation, endothelial dysfunction (ED) or insulin resistance (IR). However, MetSrelated increases in stiffness may not be uniformly distributed over muscular and elastic arteries. Therefore, the purpose of this study was to determine: (1) the associations between the MetS, and muscular and elastic arterial stiffness, and (2) whether any such associations could be explained by inflammation, ED or IR. These questions were addressed in the Hoorn Study. MetS was defined according to the NCEP (National Cholesterol Education Program) criteria. Arterial stiffness was determined by ultrasound, tonometry and echocardiography. Inflammation, ED and IR were estimated by C-reactive protein, flow-mediated vasodilation and the homoeostatic model for the assessment of IR, respectively. The results showed that MetS was associated with both femoral and brachial arterial stiffness, significantly so for the distensibility coefficients and for the femoral compliance coefficient. In the carotid artery and aorta, no particular pattern emerged. Additional adjustment for either inflammation, ED or IR did not materially alter the results. The results therefore indicate that muscular arteries may stiffen preferentially over elastic arteries and that distensibility is affected to a greater extent than compliance, thus maintaining volume compliance over vessel wall stiffening. Additionally, the increase in stiffness was not explained by inflammation, ED or IR and suggests that stiffening of the muscular arteries in MetS may not be the consequence of these phenomena.

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“…Increased stiffness of the arteries in the lower limbs is associated with impaired arterial blood flow (14,30), subclinical hypoxia of the foot (15), and ischemic symptoms of the lower extremities (16). Thus, the decreased PWV in the leg arteries following atorvastatin treatment may have beneficial effects on local blood flow, accounting for the favorable effects on walking performance (6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

“…Stiffening of the aorta impairs coronary perfusion, and reflects an increased risk of cardiovascular mortality in high-risk populations (9-12) including diabetes mellitus (13). We and others have shown that stiffness of the lower-limb arteries is associated with reduced diastolic blood flow of the popliteal artery (14), exercise-induced foot ischemia (15), and ischemic symptoms due to PAD (16) in patients with type 2 diabetes mellitus.…”

Section: Introductionmentioning

confidence: 87%

Effect of Atorvastatin on Regional Arterial Stiffness in Patients with Type 2 Diabetes Mellitus

Shinohara

Shoji

Kimoto

et al. 2005

JAT

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Objective: A statin, a potent lipid-lowering drug, improves pain-free walking distance in patients with peripheral arterial disease (PAD) without increasing the ankle-brachial pressure index (ABI). Arterial stiffness affects the blood flow of peripheral arteries. The purpose of this study was to evaluate the effect of cholesterol-lowering with atorvastatin on regional arterial stiffness in patients with type 2 diabetes mellitus. Methods: The subjects were 22 type 2 diabetic patients with hypercholesterolemia, who received atorvastatin at a daily dose of 10 mg for 6 months. Before and after the treatment with atorvastatin, we measured pulse wave velocity (PWV) in the heartbrachial, heart-carotid, heart-femoral and femoral-ankle segments. Results: Following treatment with atorvastatin, femoral-ankle PWV showed a significant reduction. The PWV of other arterial segments tended to decrease, although the changes were not statistically significant. We found no significant changes in blood pressure, heart rate, ABI, or plasma concentrations of glucose, L-arginine and asymmetric dimethylarginine (

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Arterial wall stiffness is associated with peripheral circulation in patients with type 2 diabetes

Cited by 48 publications

References 31 publications

Estimated Glomerular Filtration Rate and Urinary Albumin Excretion Are Independently Associated with Greater Arterial Stiffness

Estimated Glomerular Filtration Rate and Urinary Albumin Excretion Are Independently Associated with Greater Arterial Stiffness

The metabolic syndrome in elderly individuals is associated with greater muscular, but not elastic arterial stiffness, independent of low-grade inflammation, endothelial dysfunction or insulin resistance—The Hoorn Study

Effect of Atorvastatin on Regional Arterial Stiffness in Patients with Type 2 Diabetes Mellitus

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