Peripheral Arterial Stiffness Is Independently Associated with a Rapid Decline in Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes

Abstract

Introduction. Diabetes and its vascular complications are main noncommunicable chronic diseases and major global health issues. Peripheral arterial disease (PAD) is highly prevalent in diabetes with nephropathy. We evaluated the associations of variables of arterial stiffness and the decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes. Materials and Methods. A total of 577 type 2 diabetic patients (mean ± SD: age, 63 ± 11 years) were enrolled. A rapid decline in eGFR was defined as progressively lower eGFR detected at both the 6- and 12-month follow-up visits, plus a reduction in eGFR more than 3 mL·min−1per 1.73 m2 per year. Results. Higher glycated hemoglobin (HbA1c), systolic blood pressure (SBP), pulse pressure (PP), and brachial-ankle pulse wave velocity (ba-PWV) at baseline were independently associated with a rapid decline in eGFR. The adjusted odds ratios (95% confidence intervals) for a rapid decline in eGFR for ba-PWV, SBP, and PP were 1.072 (1.011–1.136), 1.014 (1.004–1.025), and 1.025 (1.008–1.041), respectively, after adjustment for gender, age, body mass index, smoking, HbA1c, and baseline eGFR in separated models. Conclusions. Ba-PWV may serve as a simple and noninvasive predictor of rapid renal function progression in type 2 diabetic patients.

Pattern of Peripheral Arterial Disease in Diabetic and Non Diabetic Patients: Association and Risks Correlation

“…There was also significant negative correlation between Bollinger score and GFR, while no significant correlation was found between Bollinger score and GFR in group (2). This was consistent with a study conducted by Sheen et al, (11) In our study there was significant difference between the groups regarding total cholesterol and triglycerides being higher among group (1). Moreover, there was significant positive correlation between Bollinger score and each of total cholesterol and triglycerides in both study groups.…”

Clinical predictive factors in diabetic kidney disease progression

“…In a shift from the blood test dominated approach to risk stratification, Sheen et al . have recently advocated for clinical assessment of peripheral arterial stiffness.…”

Systolic blood pressure as a predictor of incident albuminuria and rapid renal function decline in type 2 diabetic patients

“…Values of systolic blood pressure (SBP), diastolic blood pressure (DBP), and ABI were measured using the Vascular Profiler 1000 (Colin Co. Ltd., Komaki, Aichi, Japan), pulse pressure (PP) was calculated as SBP minus DBP. The measurements and validation of ABI were performed as previously described (Motobe et al, 2005;Sheen et al, 2013). Patients were in the supine position and rested for at least 5 minutes in an air-conditioned room (approximately 25°C) before SBP, DBP, and electrocardiogram data were recorded simultaneously.…”

“…Diabetic nephropathy shares many risk factors with cardiovascular disease (Luo et al, 2010;Sheen, Lin, Li, Bau, & Sheu, 2013), and usually occurs in conjunction with various metabolic abnormalities, such as hyperglycemia (Coresh, Astor, Greene, Eknoyan, & Levey, 2003;Ritz, 2008), dyslipidemia (Chawla et al, 2010;Lee et al, 2009), or overweight/obesity (Inker et al, 2014;Jindal et al, 2013); hypertension Haroun et al, 2003;Whelton, Perneger, He, & Klag, 1996); and smoking (Ritz, 2008). Traditionally, two biomarkers, namely the glomerular filtration rate (GFR) and albuminuria, have been used for the diagnosis, severity classification, and outcome prediction of chronic kidney disease (CKD).…”