Different Impacts of Cardiovascular Risk Factors on Arterial Stiffness versus Arterial Wall Thickness in Japanese Patients with Type 2 Diabetes Mellitus

Abstract

Aim:We statistically investigated whether the impact of cardiovascular risk factors on arterial stiffness would be different from that on arterial wall thickness. Methods: We analyzed 1648 Japanese type 2 diabetic patients. Arterial stiffness was evaluated by pulse wave verbosity (PWV) and wall thickness was assessed with carotid intima-media thickness (IMT) by ultrasonography. We developed a common regression model to PWV and IMT by extending the linear mixed model and statistically detected the difference in the impact of cardiovascular risk factors between the two indices. Results: There was a significant correlation between PWV and IMT (r 0.365, p 0.001). Sex, diabetic duration, hemoglobin A1c levels, and the presence of retinopathy and cardiovascular disease were comparable independent risk factors for elevated PWV and IMT. On the other hand, the impact of age, systolic blood pressure, and low-and high-density lipoprotein cholesterol levels were significantly different between the two measurements (all p 0.05). Cholesterol levels were significantly associated with IMT but not with PWV. Age and systolic blood pressure had a significant impact on both measurements, but the impact on PWV was significantly greater than that on IMT. Indeed, patients with low IMT but with advanced age and high systolic pressure had high PWV, whereas patients with low PWV but with impaired cholesterol levels had high IMT. Conclusion:The extended linear mixed model statistically confirmed that the impact of cardiovascular risk factors on elevated PWV and IMT were not identical in Japanese patients with type 2 diabetes mellitus. J Atheroscler Thromb, 2015; 22: 971-980.

High blood viscosity is associated with high pulse wave velocity in African sickle cell trait carriers

“…It is clearly established that the CVR strongly influences the increase in arterial stiffness. 25,26 In present study, there was a positive correlation between PWVft and CVR; this was confirmed in the literature for other populations than SCT.…”

Visceral Adiposity is Preferentially Associated with Vascular Stiffness Rather than Thickness in Men with Type 2 Diabetes

“…Moreover, BMI was a strong determinant of aortic PWV, but not carotid IMT, in obese T2D patients in the U.S 35) . On the other hand, dyslipidemia 21, 33) and hyperglycemia 34, 35) , but not obesity-related indices, were preferentially associated with carotid IMT in subjects with T2D. In addition, we found that only obesity-related indices were significantly different between the men with higher stiffness but lower IMT and the men with lower stiffness but higher IMT.…”

“…Differential impact of cardiovascular risk factors on arterial stiffness and IMT were also observed in Japanese patients with T2D 21, 33, 34) . Consistent with our results, several studies reported that the association with obesity-related measures was different between arterial stiffness and IMT 21, 35) .…”

Levels of Serum Phosphorus and Cardiovascular Surrogate Markers

“…Recent studies have even reported that arterial calcification could be found in the earlier course of atherosclerosis as a circumferential lesion 21) . Actually, arterial stiffness may share a lot of cardiovascular risk factors with atherosclerosis, such as age, sex, hemoglobin A1c, systolic blood pressure, and serum cholesterol, as shown in a study in patients with type 2 diabetes mellitus exploring the risk factors for baPWV and intima-media thickness 22) . Furthermore, the locations of stiffening have some differences between the selected markers.…”