High glomerular filtration rate is associated with impaired arterial stiffness and subendocardial viability ratio in prediabetic subjects

Pino, Antonino Di; Scicali, Roberto; Marchisello, Simona; Zanoli, Luca; Ferrara, Viviana; Urbano, Francesca; Filippello, Agnese; Mauro, Stefania Di; Scamporrino, Alessandra; Piro, Salvatore; Castellino, Pietro; Rabuazzo, Agata Maria

doi:10.1016/j.numecd.2021.08.030

Cited by 13 publications

(10 citation statements)

References 36 publications

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“…Pulse wave velocity . The SphygmoCor CvMS (AtCor Medical, Sydney, Australia) system was used for the determination of the pulse wave velocity (PWV), as previously described [ 28 ]. This system uses a tonometer, and two different pressure waves obtained at the common carotid artery (proximal recording site) and at the femoral artery (distal recording site).…”

Section: Methodsmentioning

confidence: 99%

Increased Platelet Reactivity and Proinflammatory Profile Are Associated with Intima–Media Thickness and Arterial Stiffness in Prediabetes

Marco

Urbano

Filippello

et al. 2022

JCM

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Alterations of glucose homeostasis are associated with subclinical vascular damage; however, the role of platelet reactivity in this process has not been fully investigated. In this cross-sectional study, we evaluated the correlation between markers of platelet reactivity and inflammation and markers of vascular disease in subjects with prediabetes. Markers of platelet reactivity such as 11-dehydro-thromboxane B2 urinary levels (11-dh-TXB2) and mean platelet volume (MPV) and inflammatory indexes such as platelet-to-lymphocyte ratio (PLR) were evaluated in subjects with prediabetes (n = 48), new-onset type 2 diabetes (NODM, n = 60) and controls (n = 62). Furthermore, we assessed the cardiovascular risk profile of the study population with arterial stiffness and quality intima–media thickness (qIMT). Subjects with prediabetes and NODM exhibited higher 11-dh-TXB2 urinary levels and MPV and a proinflammatory profile with an increased PLR, high-sensitivity C-reactive protein, ferritin and fibrinogen. Furthermore, after multiple regression analyses, we found that urinary 11-dh-TXB2 was one of the major determinants of IMT and arterial stiffness parameters. In conclusion, subjects with prediabetes exhibit increased platelet reactivity as well as a proinflammatory profile. Furthermore, this condition is associated with early markers of cardiovascular disease.

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Section: Methodsmentioning

confidence: 99%

Increased Platelet Reactivity and Proinflammatory Profile Are Associated with Intima–Media Thickness and Arterial Stiffness in Prediabetes

Marco

Urbano

Filippello

et al. 2022

JCM

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“…Clinical studies, however, highlight the presence of altered values of arterial stiffness parameters in diabetic patients. Di Pino et al [ 43 ] have shown that patients with prediabetes and high glomerular filtration rate values have increased augmentation pressure and AIx values and reduced SEVR values ( p < 0.05). In patients with type 1 diabetes mellitus, reduced SEVR values correlate independently and negatively with the presence and degree of microalbuminuria and are a superior predictor of PWV in assessing the albumin excretion rate [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a more recent clinical trial, the same group of investigators demonstrated that chronic kidney disease patients with an SEVR of less than 130% were associated with a 16-fold increased risk of fatal cardiovascular events compared to patients with an SEVR greater than 130% ( p = 0.004) [ 46 ]. Not only do low eGFR values correlate with SEVR, but high ones do as well, with the main determinants of SEVR in the prediabetic population being SBP, eGFR and insulin resistance as major determinants of arterial stiffness [ 43 ]. Based on the concept that a significant percentage of hypertensive patients are associated with peripheral arterial disease, the analysis of paraclinical parameters of arterial stiffness has prognostic value.…”

Section: Discussionmentioning

confidence: 99%

Subendocardial Viability Ratio Predictive Value for Cardiovascular Risk in Hypertensive Patients

et al. 2022

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Background: The subendocardial viability ratio (SEVR), also known as the Buckberg index, is a parameter of arterial stiffness with indirect prognostic value in assessing long-term cardiovascular risk. Materials and Methods: We conducted a prospective cohort study on 70 patients with uncomplicated hypertension admitted to a county medical reference hospital. We analyzed demographics, laboratory data, arterial stiffness parameters and cardiovascular risk scores (SCORE and Framingham risk scores) and aimed to identify paraclinical parameters associated with increased cardiovascular risk. Results: Of the arterial stiffness parameters, SEVR correlates statistically significantly with age, central and peripheral systolic blood pressure, as well as with heart rate. SEVR seems to have prognostic value among hypertensive patients by increasing the risk of major cardiovascular events assessed by SCORE and Framingham risk scores. SEVR correlates statistically significantly with serum fibrinogen (p = 0.02) and hemoglobin (p = 0.046). Between pulse wave velocity and lipid parameters (p = 0.021 for low-density lipoprotein cholesterol <LDL> and p = 0.030 for triglycerides) a statistically significant relationship was found for the study group. The augmentation index of the aorta also correlated with serum LDL-cholesterol (p = 0.032) and the hemoglobin levels (p = 0.040) of hypertensive patients. Conclusions: Age, abdominal circumference and Framingham score are independent predictors for SEVR in our study group, further highlighting the need for early therapeutic measures to control risk factors in this category of patients.

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“…The classic description of DKD involves progressive stages of glomerular hyperfiltration, microalbuminuria, overt proteinuria, and a decline in the estimated glomerular filtration rate (eGFR), eventually leading to dialysis [3,4]. In the last few years, this concept has been increasingly challenged as evidence suggests that DKD in the contemporary era presents in a more heterogeneous manner.…”

Section: Non-albuminuric Phenotype: Clinical Presentation Epidemiolog...mentioning

confidence: 99%

Update on Diabetic Kidney Disease (DKD): Focus on Non-Albuminuric DKD and Cardiovascular Risk

et al. 2023

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The classic description of diabetic kidney disease (DKD) involves progressive stages of glomerular hyperfiltration, microalbuminuria, proteinuria, and a decline in the estimated glomerular filtration rate (eGFR), leading to dialysis. In recent years, this concept has been increasingly challenged as evidence suggests that DKD presents more heterogeneously. Large studies have revealed that eGFR decline may also occur independently from the development of albuminuria. This concept led to the identification of a new DKD phenotype: non-albuminuric DKD (eGFR < 60 mL/min/1.73 m2, absence of albuminuria), whose pathogenesis is still unknown. However, various hypotheses have been formulated, the most likely of which is the acute kidney injury-to-chronic kidney disease (CKD) transition, with prevalent tubular, rather than glomerular, damage (typically described in albuminuric DKD). Moreover, it is still debated which phenotype is associated with a higher cardiovascular risk, due to contrasting results available in the literature. Finally, much evidence has accumulated on the various classes of drugs with beneficial effects on DKD; however, there is a lack of studies analyzing the different effects of drugs on the various phenotypes of DKD. For this reason, there are still no specific guidelines for therapy in one phenotype rather than the other, generically referring to diabetic patients with CKD.

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High glomerular filtration rate is associated with impaired arterial stiffness and subendocardial viability ratio in prediabetic subjects

Cited by 13 publications

References 36 publications

Increased Platelet Reactivity and Proinflammatory Profile Are Associated with Intima–Media Thickness and Arterial Stiffness in Prediabetes

Increased Platelet Reactivity and Proinflammatory Profile Are Associated with Intima–Media Thickness and Arterial Stiffness in Prediabetes

Subendocardial Viability Ratio Predictive Value for Cardiovascular Risk in Hypertensive Patients

Update on Diabetic Kidney Disease (DKD): Focus on Non-Albuminuric DKD and Cardiovascular Risk

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