Association between neutrophil–lymphocyte ratio on arterial stiffness in type-2 diabetes mellitus patients: a part of DiORS Study

Ardiany, Deasy; Pranoto, Agung; Soelistijo, Soebagijo Adi; Libriansyah,; Widjaja, Sauli Ari

doi:10.1007/s13410-021-00965-1

Cited by 10 publications

(7 citation statements)

References 30 publications

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“…24 Inflammation has a pivotal role in both arterial stiffening and atherosclerosis. 25 In an in vitro study, C-reactive protein (CRP) decreased endothelial NO synthase (NOS) secretion and activity, resulting in "functional" arterial stiffening. Furthermore, inflammation may result in dysregulation between elastin breakdown and production.…”

Section: Discussionmentioning

confidence: 99%

The performance of lipid profiles and ratios as a predictor of arterial stiffness measured by brachial-ankle pulse wave velocity in type 2 diabetic patients

et al. 2022

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Background: Early identification of arterial stiffness in Type 2 diabetes mellitus (T2DM) patients before the manifestation of atherosclerosis would be clinically beneficial. Our study aimed to explore the correlation of lipid profiles and ratios with arterial stiffness, and construct a predictive model for arterial stiffness in T2DM patients using those parameters. Methods: One hundred and eighty-four adult T2DM patients in the diabetes outpatient clinic at the Dr. Soetomo general academic hospital were enrolled in this cross-sectional study in 2015 and 2019. Sociodemographic, glycosylated hemoglobin (HbA1c), lipid profiles, and brachial-ankle pulse wave velocity (ba-PWV) data were collected from all subjects. The subjects were divided into a group with arterial stiffness (ba-PWV > 18 m/sec) and without arterial stiffness (ba-PWV ≤ 18 m/sec). A correlation test was used to evaluate the association, and receiver operator characteristics (ROC) curves analysis were used to determine the cut-off value, sensitivity, and specificity. The risk analysis model was calculated using bivariate logistic regression analysis. Results: The group with arterial stiffness had higher lipid profiles: total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipid ratios. A significant positive correlation was found between TC, TG, LDL-C, and all lipid ratios with ba-PWV. A negative correlation was found between HDL-C and ba-PWV. All lipid ratio parameters can be used as predictors of arterial stiffness, especially non-HDL-C with cut-off value: 150 mg/dL (sensitivity 96.8% and specificity 52.9%) and TG/HDL-C ratio with cut-off value: 4.51 (sensitivity 81.0% and specificity 74.2%). Elevated TG/HDL-C ratio and non-HDL-C displayed higher risk (OR: 12.293 and 16.312; p < 0.05) of having arterial stiffness compared to other lipid ratios. Conclusions: Lipid profiles and lipid ratios, especially TG/HDL-C ratio and non-HDL-C, are potential biochemical markers for arterial stiffness in T2DM patients.

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Section: Discussionmentioning

confidence: 99%

The performance of lipid profiles and ratios as a predictor of arterial stiffness measured by brachial-ankle pulse wave velocity in type 2 diabetic patients

et al. 2022

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“…Assessment of arterial stiffness was done by measuring brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) that were calculated automatically in supine position using Vasera VS-1000 (Fukuda Denshi Co. Ltd, Tokyo, Japan) after at least a 5 min rest period, as done previously by our study group [ 22 ]. The baPWV and ABI assessment were recorded from both sides and the average was used for further analysis.…”

Section: Methodsmentioning

confidence: 99%

Retinal neurovascular alteration in type 2 diabetes with renal impairment in association with systemic arterial stiffness

Ari Widjaja,

Mieler,

Sasono

et al. 2024

Int J Retin Vitr

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Background Diabetic retinopathy (DR) patients should be alert for subclinical macroangiopathy. We aimed to investigate the association between retinal neurovascular alteration and systemic arterial stiffness in type 2 diabetes mellitus (type 2 DM) patients with varying degrees of renal impairment. Methods The study included 170 patients with confirmed diagnosis of type 2 DM aged ≥18 years old. Renal function was assessed by estimated glomerular filtration rate (eGFR). Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI). Retinal neurovascular parameters were derived from Optical Coherence Tomography (OCT)/OCT-Angiography, represented by vessel density (VD Central, Inner, Outer, Full), foveal avascular zone (FAZ area and FAZ perimeter) of the superficial capillary plexus, the average of macular ganglion cell-inner plexiform layer thickness (ave mGC-IPLt) and the average of retinal nerve fiber layer thickness (aveRNFLt). The association between variables among the groups (according to renal function, diabetic retinopathy (DR) severity, and arterial stiffness categories) were analyzed by regression analysis with multiple hypothesis testing commands. Results Out of the 265 eyes, the mean DM duration and HbA1c were 6.21 ± 6.37 years and 8.44 ± 2.06% respectively. While the mean of eGFR, baPWV and ABI were 66.78 ± 32.80 ml/min/1.73m2, 15.49 ± 3.07 m/s, and 1.05 ± 0.12, respectively. Patients with more severe renal impairment demonstrated longer DM duration (p < 0.001), higher baPWV (p < 0.0001), and retinal vascular alteration. Proliverative DR group showed the lowest eGFR (p < 0.0001), highest baPWV (p < 0.0001), and retinal neurovascular changes. Significantly lower eGFR and retinal vascular alteration were found in the baPWV > 14 group. Some neurovascular parameters were significantly negatively correlated with baPWV; moreover, retinal neurovascular changes were also noted in the abnormal ABI group. Conclusions The strong association between changes in the retinal neurovascular system, DR severity, renal impairment, and arterial stiffness in type 2 DM was confirmed. Patients with more severe renal impairment had higher levels of arterial stiffness, more severe DR and retinal neurovascular alteration. Retinal neurovascular changes seen in OCT/OCTA might mimic renal microvascular alteration and systemic arterial stiffness. Therefore, assessment of baPWV and OCT/OCTA should be integrated in DR screening to enhance cardiovascular risk stratification and prognosis as well as to provide clinically useful early identification of subclinical micro- and macrovascular alterations.

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“…Participants in this study were patients diagnosed with T2DM [ 9 , 10 ]. Participant inclusion criteria included patients diagnosed with T2DM (HbA1c of ≥6.5%, fasting plasma glucose of ≥126 mg/dL, 2-h plasma glucose & random plasma glucose ≥200 mg/dL) [ 11 , 12 ], and consuming statins.…”

Section: Methodsmentioning

confidence: 99%

Profile of cardiovascular disease risk in type 2 diabetes mellitus patients receiving statin therapy: A cross-sectional study

Ikhsan¹,

Soelistijo²,

Putranto³

2022

Annals of Medicine &Amp; Surgery

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Association between neutrophil–lymphocyte ratio on arterial stiffness in type-2 diabetes mellitus patients: a part of DiORS Study

Cited by 10 publications

References 30 publications

The performance of lipid profiles and ratios as a predictor of arterial stiffness measured by brachial-ankle pulse wave velocity in type 2 diabetic patients

The performance of lipid profiles and ratios as a predictor of arterial stiffness measured by brachial-ankle pulse wave velocity in type 2 diabetic patients

Retinal neurovascular alteration in type 2 diabetes with renal impairment in association with systemic arterial stiffness

Profile of cardiovascular disease risk in type 2 diabetes mellitus patients receiving statin therapy: A cross-sectional study

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