Positive association between baseline brachial–ankle pulse wave velocity and the risk of new-onset diabetes in hypertensive patients

Abstract

Background There is no clearly defined temporal relationship between arterial stiffness and diabetes. We aimed to investigate the prospective association between baseline brachial–ankle pulse wave velocity (baPWV) and the risk of new-onset diabetes during follow-up, and examined whether there were effect modifiers, in hypertensive patients. Methods We included 2429 hypertensive patients with all the pertinent data but without diabetes at the baseline, who were part of the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, actively controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose (FG) ≥ 126.0 mg/dL at the exit visit. Results During a median follow-up duration of 4.5 years, 287 (11.8%) participants developed diabetes. There was a significant positive association between baseline baPWV and the risk of new-onset diabetes (per SD increment; OR, 1.33; 95% CI 1.13, 1.56). Consistently, when baPWV was assessed as quartiles, a significantly higher risk of new-onset diabetes was found in participants in quartiles 2–4 (≥ 15.9 m/s; OR, 1.80; 95% CI 1.22, 2.65) compared with those in quartile 1 (< 15.9 m/s). The positive association was consistent in participants with (per SD increment; OR, 1.29; 95% CI 1.06, 1.56) or without (per SD increment; OR, 1.40; 95% CI 1.15, 1.71) impaired fasting glucose (IFG, FG ≥ 100.8 and < 126.0 mg/dL, P -interaction = 0.486). Conclusions In this sample of hypertensive patients, we found a significant positive association between baseline baPWV and the risk of new-onset diabetes. Clinical trial registration Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008

Arterial stiffness is an independent predictor for risk of mortality in patients with type 2 diabetes mellitus: the REBOUND study

“…Yiming et al demonstrated that the reference values of baPWV were significantly higher in subjects with diabetes than in normal subjects, after adjustment for age and mean blood pressure [ 26 ]. Zhang et al reported a positive association between baPWV and the risk of new-onset diabetes in hypertensive patients [ 27 ]. It is possibly caused by advanced glycation end product formation with collagen cross-linking, oxidative stress, inflammatory process, and insulin resistance [ 28 – 31 ].…”

Use of the ankle-brachial index combined with the percentage of mean arterial pressure at the ankle to improve prediction of all-cause mortality in type 2 diabetes mellitus: An observational study

“…Third, insulin resistance can increase the vessel tone by activating endothelin-1 and angiotensin II type 1 receptors [40,41], and the Atherosclerosis Risk in Communities Study reported that insulin resistance was associated with arterial stiffness in patients with type 2 DM [42]. Arterial stiffness with high baPWV was also reported to be associated with new-onset DM [43]. Furthermore, a high prevalence of medial arterial calci cation was reported in patients with DM [44,45].…”

Ferritin modifies the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance

“…In recent years the interrelationship between ferritin, glucose metabolism, arterial stiffness and in ammation has been extensively investigated. Scienti c evidence has shown that high glucose levels also in the prediabetic range and insulin resistance might lead to increased arterial stiffness and cardiac concentric remodeling [27], moreover in a sample of hypertensive patients a signi cant positive association between baseline brachial-ankle PWV and the risk of new-onset diabetes was found [28]. Also serum ferritin levels have been associated with new-onset T2DM risk in Chinese [29] and Korean [30] populations and with increased arterial stiffness in healthy Korean adults [20].…”