Clinical interaction between diabetes duration and aortic stiffness in type 2 diabetes mellitus

Abstract

Diabetes complications increase with disease duration. No study was performed on the relationship between aortic stiffness and diabetes duration, taking into account the respective influence of such factors on macro- and microcirculation. In total, 618 subjects with type 2 diabetes (259 men) attending the Department of Internal Medicine of Tizi Ouzou Hospital (Algeria) were studied in collaboration with Hotel-Dieu Hospital (Paris, France). Brachial blood pressure (BP), anthropometric, clinical and biological data were evaluated. Aortic stiffness was estimated by carotid-femoral pulse wave velocity (PWV). From lower to higher tertile of diabetes duration, age, BP and PWV (10.1±2.7 to 12.3±2.8 m s) increased, while diabetes control and renal function worsened (all P<0.01). Diabetes duration was independently associated with PWV (R=0.035, P<0.0001), even after adjustment for age, BP, heart rate, cardiovascular events and metabolic syndrome. Diabetes duration was significantly correlated to the prevalence of microalbuminuria (OR (95% CL) 1.3 (1.06-1.63), P=0.01), independently of age, sex, BP and renal function. Increased aortic stiffness was independently associated with the prevalence of cardiovascular events (P<0.001), reaching its maximal value above the first 2 years of diabetes duration. In conclusion, diabetes duration is an independent determinant of aortic stiffness in subjects with type 2 diabetes, representing about 4% of PWV variability. Diabetes duration is associated with microvascular complications independently of renal function, and with macrovascular complications through the presence of increased aortic stiffness.

Associations between Type 2 Diabetes Mellitus and Arterial Stiffness: A Prospective Analysis Based on the Maine-Syracuse Study

“…This finding supports the work of others [27,28,29]. Agnoletti et al [28] examined 618 T2DM patients and showed that across increasing tertiles of T2DM duration PWV increased significantly, while glycaemic control and renal function worsened [28].…”

“…Agnoletti et al [28] examined 618 T2DM patients and showed that across increasing tertiles of T2DM duration PWV increased significantly, while glycaemic control and renal function worsened [28]. T2DM duration was independently associated with PWV, explaining about 4% of PWV variability from low to high tertiles [28]. Positive results have, therefore, been demonstrated with adjustment for CVD variables, large sample sizes and long durations of measurement.…”

Prognostic significance of the renal resistive index in the primary prevention of type II diabetes

“…RRI is dependent on systemic hemodynamic factors [8][9][10][11][12][13][14][15] and varies with the heart rate. 16 A significant decrease in RRI was observed with an increasing heart rate.…”

“…At this time, the renal Doppler ultrasound was used to screen for significant renal artery stenosis 9…”

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

“…Major factors that appear to affect arterial stiffness in these patients are age, heart rate, and insulin treatment . Other factors that have been implicated into arterial stiffening include mean arterial pressure, pre‐existing CVD, concomitant metabolic syndrome, and plasma glucose levels . In a sub‐analysis of the Atherosclerosis Risk in Communities (ARIC) study, it was shown that among the elderly, T2DM has a significant, positive correlation with arterial stiffness, compared to IGT and normal glucose tolerance, while it was also documented that arterial stiffness significantly correlates with glycemic control, T2DM duration, and established diabetic nephropathy .…”