Is visceral adiposity a modifier for the impact of blood pressure on arterial stiffness and albuminuria in patients with type 2 diabetes?

Abstract

BackgroundWe aimed to investigate whether visceral adiposity could modify the impact of blood pressure on arterial stiffness and albuminuria in patients with type 2 diabetes.MethodsThis cross-sectional study examines the interaction of visceral adiposity with increased blood pressure on arterial stiffness and albuminuria. 638 patients with type 2 diabetes (mean age 64 ± 12 years; 40 % female) were enrolled. Visceral fat area (VFA, cm2) was assessed by a dual-impedance analyzer, whereby patients were divided into those with VFA < 100 (N = 341) and those with VFA ≥ 100 (N = 297). Albuminuria was measured in a single 24-h urine collection (UAE, mg/day) and brachial-ankle pulse wave velocity (ba-PWV, cm/s) was used for the assessment of arterial stiffening. Linear regression analyses were used to investigate the association of systolic blood pressure (SBP) and VFA with UAE and baPWV.ResultsPatients with VFA ≥ 100 were significantly younger, had higher SBP, HbA1c, triglycerides, UAE, alanine aminotransferase, C-reactive protein and lower high-density lipoprotein and shorter duration of diabetes than those with VFA < 100. SBP was significantly and almost equivalently associated with ba-PWV both in VFA < 100 (standardized β 0.224, p = 0.001) and VFA ≥ 100 (standardized β 0.196, p = 0.004) patients in the multivariate regression analysis adjusting for covariates including age, gender, HbA1c, diabetic complications and the use of insulin and anti-hypertensive agents. By contrast, the association of SBP with UAE was stronger in patients with VFA ≥ 100 (standardized β 0.263, p = 0.001) than that in patients with VFA < 100 (standardized β 0.140, p = 0.080) in the multivariate regression model. In the whole cohort, the significant interaction between SBP and VFA on UAE (standardized β 0.172, p = 0.040) but not on ba-PWV (standardized β −0.008, p = 0.916) was observed.ConclusionsThe effect of increased blood pressure on arterial stiffness is almost similar in type 2 diabetic patients with both low and high visceral adiposity, while its association with albuminuria is stronger in the latter.

Low muscle quality in Japanese type 2 diabetic patients with visceral fat accumulation

“…The exact etiology of cardiovascular diseases and decreased muscle quality in T2DM with visceral fat accumulation is unknown. Dysregulation of adipocytokines/adipokines, such as hypoadiponectinemia, has been reported previously [ 40 ], and the high levels of inflammatory cytokines in the accumulated visceral fat could result in systemic low-grade inflammation, insulin resistance, microalbuminuria [ 41 , 42 ], arterial stiffness [ 43 ], and atherosclerotic cardiovascular diseases [ 40 , 44 ]. In fact, hypercytokinemia, including high serum levels of tumor necrosis factor-α and interleukin 6 (IL-6), has been reported to be associated with both muscle mass and muscle strength in the elderly [ 45 , 46 ].…”

Abdominal subcutaneous adipose tissue: a favorable adipose depot for diabetes?

“…As a cardiometabolic disease, diabetes is associated with 2–4 times higher risk of CVD and it double the risk of cardiovascular mortality [ 38 – 41 ]. Previous studies have documented that ectopic fat accumulation, mainly visceral adipose tissue, acting through the potential inflammatory response and oxidative phosphorylation pathways [ 42 ], is a risk factor of metabolic disorders, atherosclerosis, and CVD [ 3 , 43 – 45 ]. The failure of visceral adipose tissue to store triglyceride could result in an increase of epicardial adipose tissue thickness [ 46 ].…”

Lipopolysaccharide-binding protein is associated with arterial stiffness in patients with type 2 diabetes: a cross-sectional study

“…Aortic PWV has also been established as an independent predictor of future cardiovascular events and mortality [27, 28]. Recent studies have shown a close association between blood pressure and arterial stiffness as evaluated by brachial-ankle PWV [29] in patients with type 2 diabetes, and a predictive value of brachial-ankle PWV on the progression of coronary artery calcification [30] The results from the present study are in agreement with those of the previous study [15] and indicate a possible role of LBP in the progression of atherosclerosis. Furthermore, this study is the first to report the impact of LBP on arterial stiffness in patients with type 2 diabetes, who have advanced arterial stiffening [22, 27, 31–33] and elevated cardiovascular mortality [34].…”