Effects of Glucose Metabolism on Aortic Pulse Wave Velocity in Hemodialysis Patients with and without Diabetes

Matsumae, Tomoji; Abe, Yasuhiro; Murakami, Genji; Saito, Takao

doi:10.1291/hypres.31.1365

Cited by 14 publications

(18 citation statements)

References 33 publications

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“…There is controversy over the effect of disorders of lipid metabolism on aortic compliance. In several cross-sectional studies, lipid profile was not a determinant of PWV, 5,6,9,29 whereas serum triglyceride correlated positively with ba-PWV in hemodialysis patients 30 and increments in ba-PWV. 28 Furthermore, intermediate-density lipoprotein cholesterol, which contains cholesterol and triglyceride, was an independent risk factor for arteriosclerosis.…”

Section: Discussionmentioning

confidence: 88%

“…In our previous cross-sectional study, 9 242 patients who had been treated by regular HD for more than 6 months at Murakami Memorial Hospital, Japan, underwent measurements of carotid-femoral PWV (cfPWV) and ankle-brachial blood pressure index (ABPI). Of these, 148 patients who could be followed up after 3 years from baseline measurements were enrolled in this study.…”

Section: Study Design and Patientsmentioning

confidence: 99%

“…Recently, we described that hemoglobin A1c was an independent contributor to aortic PWV not only in diabetic HD patients, but also in non-diabetic HD patients. 8,9 However, there have been only a few studies that elucidated the factors that contribute to the rate of progression of arterial stiffening in ESRD patients treated with HD.…”

Section: Introductionmentioning

confidence: 99%

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What factors accelerate aortic stiffening in hemodialysis patients? An observational study

Matsumae¹,

Abe

Nishimura³

et al. 2010

Hypertens Res

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Increased aortic stiffness is an independent predictor of death from cardiovascular disease in patients with end-stage renal disease (ESRD). Various factors that contribute to carotid-femoral pulse wave velocity (cfPWV) as a surrogate of aortic stiffness have been identified, but determinants of long-term worsening of aortic stiffness remain to be elucidated. To clarify the factors that accelerate aortic stiffness in hemodialysis patients, 148 patients with ESRD on hemodialysis were evaluated. At baseline, cfPWV and ankle-brachial blood pressure index (ABPI) were measured and clinical status including biochemical parameters, with or without hepatitis c virus (HCV) infection, diabetes mellitus (DM), cardiovascular disease, cerebrovascular disease and peripheral arterial disease at baseline, were evaluated. The cfPWV was measured again after a 3-year follow up and the annual change in cfPWV was calculated. The cfPWV decreased in 54 patients, worsened slowly in 47 (annual change in cfPWV ranged from 0 to 0.33 m s À1 per year), and worsened rapidly in 47 patients (annual change in cfPWV was more than 0.33 m s À1 per year). The prevalences of DM, HCV infection and peripheral arterial disease were the highest in the rapid progression group. Univariate analysis showed that age, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), LDL-C/HDL-C ratio, HCV infection, ABPI and number of vasculopathies were significantly associated with annual change in cfPWV. Stepwise regression analysis identified ABPI, LDL-C/HDL-C ratio and HCV infection as independent determinants of worsening of cfPWV. Further studies are needed to investigate the mechanism of HCV-related enhancement of aortic stiffness in ESRD patients.

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Section: Discussionmentioning

confidence: 88%

Section: Study Design and Patientsmentioning

confidence: 99%

See 1 more Smart Citation

What factors accelerate aortic stiffening in hemodialysis patients? An observational study

Matsumae¹,

Abe

Nishimura³

et al. 2010

Hypertens Res

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“…Poor glycemic control of HbA1c >6.3% was shown to be an independent predictor of poor prognosis for all-cause mortality, even after adjusting for age, gender and HD duration [15]. In addition, several reports demonstrated that HbA1c was an independent predictor of aortic wall stiffness, both in diabetic and nondiabetic HD patients [16,17]. …”

Section: Introductionmentioning

confidence: 99%

Glycated Hemoglobin Predicts Mortality in Nondiabetic Patients Receiving Chronic Peritoneal Dialysis

et al. 2010

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Background: Patients with chronic peritoneal dialysis (CPD) use glucose-based dialysate to maintain their life; however, whether the glycemic status influences outcome of these patients without diabetes remains unknown. Methods: We conducted a cross-sectional and 18-month prospective study, and 269 nondiabetic patients with CPD were enrolled in a medical center. Glycated hemoglobin (HbA1c) levels were measured at baseline and categorized in tertiles of HbA1c: high (>5.4%), middle (5.1–5.4%) and low normal (<5.1%). Mortality and cause of death were recorded for longitudinal analyses. Results: The study results showed high HbA1c group patients had a trend of being older and having higher body mass index (BMI) than other group patients. Stepwise multiple linear regression analysis showed HbA1c was positively related to age, BMI and the peritoneal solute transport rate. After 18 months of follow-up, Cox multivariate analysis showed that HbA1c (HR: 4.114; 95% CI: 1.426–11.872; p = 0.009) was the significant risk factor for all-cause mortality after relating variables were adjusted. Moreover, high HbA1c (HR: 3.892; 95% CI: 1.273–11.959; p = 0.026) and low HbA1c (HR: 1.179; 95% CI: 1.160–1.198; p = 0.039), with middle HbA1c group as the reference, also significantly predicted for mortality in these patients. Conclusions: HbA1c levels, or presence of low or high HbA1c, are associated with 18-month all-cause mortality in nondiabetic patients with CPD.

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“…20,21 Indeed, our earlier study 20 showed that the frequency of PAD, defined as o0.9 by the ankle-brachial pressure index (ABPI), was 43.6% in diabetic HD patients and 28.4% in non-diabetic HD patients. At present, the number of diabetic patients who need HD is growing, and patients with HD are likely to also have severe systemic atherosclerosis.…”

mentioning

confidence: 98%

Effects of Glucose Metabolism on Aortic Pulse Wave Velocity in Hemodialysis Patients with and without Diabetes

Cited by 14 publications

References 33 publications

What factors accelerate aortic stiffening in hemodialysis patients? An observational study

What factors accelerate aortic stiffening in hemodialysis patients? An observational study

Glycated Hemoglobin Predicts Mortality in Nondiabetic Patients Receiving Chronic Peritoneal Dialysis

Does carotid-ankle vascular index reflect proper vascular distensibility in hemodialysis patients?

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