Effect of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Dysglycemia, Insulin Resistance, and Dyslipidemia: a Temporal Causal Longitudinal Study

Abstract

Background: We investigated the temporal causal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) progression with the risk of dysglycemia, insulin resistance, and dyslipidemia. Methods: We included 3862, 17.7-year-old, participants from the Avon Longitudinal Study of Parents and Children, followed up for 7 years. cfPWV, cIMT, and fasting plasma samples were repeatedly measured. We computed homeostatic model assessment (HOMA) of insulin resistance and percent pancreatic beta-cell function. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models. Results: A higher cfPWV at 17.7 years was associated with higher insulin at age 24.5 years (odds ratio, 1.25 [CI, 1.08–1.44]; P =0.003), which slightly attenuated after covariates adjustment. Higher cIMT at 17.7 years was associated with lower insulin (odds ratio, 0.06 [0.01–0.95]; P =0.046) at 24.5 years, after covariate adjustments. In mixed-effect models, the 7-year progression in cfPWV was directly associated with the increase in triglyceride. cIMT progression was associated with LDL (low-density lipoprotein), triglyceride, and glucose increase. In cross-lagged models, higher cfPWV at 17.7 years was associated with higher insulin ( β =0.06, SE, 0.12, P =0.014), HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years. However, insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 17.7 years were not associated with cfPWV at 24.5 years. Higher cIMT at 17.7 years was associated with reduced insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years, but not vice versa. Higher glucose at 17.7 years was associated with higher cfPWV and cIMT at 24.5 years only. Conclusions: Arterial stiffness in adolescence may be a causal risk factor for hyperinsulinemia and insulin resistance in young adulthood.

Hypertension in Patients with Insulin Resistance: Etiopathogenesis and Management in Children

“…A higher value of HOMAIR corresponds to a more severe IR. The study showed that a higher cfPWV at 17.7 years was associated with higher HOMA index at age 24.5 years, supporting the hypothesis according to which arterial stiffness in adolescence may be a causal risk factor for hyperinsulinemia and IR in young adulthood [ 9 ].…”

Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice?

“…Therefore, it is important to identify subclinical vascular damage in patients with MS and its components who should be taken into careful consideration for appropriate treatment. Increased arterial stiffness (AS) can be considered to be a good predictor of the development of subclinical cardiovascular dysfunction, so the assessment of AS can be useful in the identification of patients with increased cardiovascular risk [ 20 , 21 ].…”

Arterial stiffness precedes hypertension and metabolic risks in youth: a review

“…Extensive details of arterial stiffness assessments, haemodynamics, physics and mechanobiology have been published earlier [5,6,9,23]. This review summarizes recent epidemiological evidence on arterial stiffness usefulness in young population [20][21][22]24] and proposes future directions.…”