Subclinical atherosclerosis is increased in type 2 diabetic patients with microalbuminuria evaluated by intima-media thickness and pulse wave velocity

Yokoyama, Hiroyuki; Aoki, T.; Imahori, Masumi; Kuramitsu, Masae

doi:10.1111/j.1523-1755.2004.00752.x

Cited by 135 publications

(147 citation statements)

References 40 publications

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“…Our findings concur with the similar associations noted in prior reports involving individuals with diabetes, 26,27 hypertension, 28 and the general population. 15,29 Our cross-sectional analysis, however, was unique for a large sample size, robust multivariable adjustment, and the use of gold standard tonometry measures for central arterial stiffness.…”

Section: Discussionsupporting

confidence: 82%

Arterial Stiffness in Mild-to-Moderate CKD

Upadhyay¹,

Hwang

Mitchell

et al. 2009

Journal of the American Society of Nephrology

133

116

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Whether arterial stiffness correlates with mild-to-moderate CKD and albuminuria in the community is unclear. We studied the association between arterial stiffness and mild-to-moderate CKD and albuminuria in the Framingham Heart Study. CKD was present in 6.7% (181 of 2682) of participants and microalbuminuria was present in 8.2% (479 of 5818). The measures of arterial stiffness were the carotid femoral pulse wave velocity, forward pressure wave amplitude, central pulse pressure, augmentation pressure, augmentation index, and mean arterial pressure. In cross-sectional analyses, arterial stiffness did not associate with CKD (defined by estimated GFR Ͻ60 ml/min/1.73 m 2 ) in either age-and gender-adjusted or multivariable-adjusted linear regression models. Carotid femoral pulse wave velocity associated with both urinary albumin-to-creatinine ratio and microalbuminuria (P Ͻ 0.0001 after multivariable adjustment). In longitudinal analyses, we used logistic regression models to examine the associations between baseline arterial stiffness measures (exposure variables) and incident CKD or microalbuminuria (n ϭ 1675 for CKD analyses and n ϭ 1252 for microalbuminuria analyses). Baseline arterial measures did not associate with incident CKD or incident microalbuminuria. In summary, arterial stiffness correlates with albuminuria but not with mild-to-moderate CKD.

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Section: Discussionsupporting

confidence: 82%

Arterial Stiffness in Mild-to-Moderate CKD

Upadhyay¹,

Hwang

Mitchell

et al. 2009

Journal of the American Society of Nephrology

133

116

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“…These findings support the so-called 'common soil' or 'ticking clock' hypothesis, which suggests that macrovascular disease associated with type 2 diabetes begins in the pre-diabetic state [15,55]. In addition, the presence of micro-and macrovascular complications in type 2 diabetes is associated with a further increase in arterial stiffness [37,41,50,[56][57][58][59]. Furthermore, as in type 1 diabetes, the agerelated increase in arterial stiffness is steeper in individuals with type 2 diabetes than in their non-diabetic counterparts [36,40,43,46].…”

Section: Estimates Of Arterial Stiffnesssupporting

confidence: 71%

Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease

2008

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Increased arterial stiffness associated with diabetes and the metabolic syndrome may in part explain the increased cardiovascular disease risk observed in these conditions. Arterial stiffness can be estimated by quantifying pulse pressure but is better described by distensibility and compliance coefficients, pulse wave velocity and wave reflection. The most common non-invasive methodologies used to quantify these estimates of arterial stiffness (e.g. ultrasonography and applanation tonometry) are also described. We then review and summarise the current data on the associations between diabetes, the metabolic syndrome and insulin resistance on the one hand and greater arterial stiffness on the other, and identify and discuss some unresolved issues such as differential stiffening of central vs peripheral arterial segments, the impact of sex, and the pathobiology of increased arterial stiffness in diabetes and the metabolic syndrome. Finally, some considerations with regard to treatment options are presented.At present the most powerful therapy available for reducing arterial stiffness is to vigorously treat hypertension using pharmacological agents. New pharmacological strategies to reduce arterial stiffness are likely to be especially relevant to individuals with diabetes.

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“…Strong positive correlation of intima-media thickness with carotid-femoral PWV has been observed in large population cohort studies 27 and in patients with diabetes. 19,40 baPWV 16,17 was also useful to predict the early stages of atherosclerosis. 18,19 In contrast, Nishi et al 41 also observed a significant but poor correlation between baPWV and intima-media thickness in subjects with diabetes and no significant relationship with baPWV in the presence of plaques.…”

Section: Macroscopic and Microscopic Findings Of The Aortamentioning

confidence: 99%

“…Some investigators reported that brachial-ankle PWV (baPWV), closely associated with AoPWV measured invasively, 16,17 was also useful to predict the early stage of atherosclerosis in obese young-adults 18 and Type 2 diabetic patients. 19 PWV can be lowered in hypertensive patients after antihypertensive therapy is performed. 20,21 The effects of atherosclerosis on PWV may be small at relatively early to middle stages if PWV is corrected for AP.…”

Section: Introductionmentioning

confidence: 99%

To what extent does aortic pulse wave velocity estimate early atherosclerosis in Kurosawa and Kusanagi-hypercholesterolemic rabbits?

et al. 2011

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Pulse wave velocity (PWV), an index of arterial stiffness, is dependent not only on structural alterations in arterial wall but also on distending pressure, which could be related to wall distensibility. We investigated the efficacy of aortic PWV (AoPWV) for detecting early to moderate atherosclerosis in Kurosawa and Kusanagi-hypercholesterolemic (KHC) rabbits. Pressure waves were recorded at the ascending, and proximal and distal abdominal aortas in 13 male normal and KHC rabbits aged 12 months under pentobarbital anesthesia when angiotensin II or sodium nitroprusside was infused intravenously. AoPWV was compared between the two rabbit groups at different mean arterial pressure (MAP) levels. Vascular diameter (D m ) was measured using an intravascular ultrasound imaging system in the proximal thoracic and proximal abdominal aortas to determine pressure-strain elastic modulus (E p ). AoPWV was correlated to MAP in the two rabbit groups (Po0.001). AoPWV was slightly but significantly greater (o0.5 m s À1 ) in the KHC rabbit group than in the normal rabbit group at MAP level 480 mm Hg (Po0.01). The value of h/D m (h, wall thickness) was significantly high in the KHC rabbit group at any MAP level (Po0.001) in these aortic regions. There was no significant difference in E p and D m between the two rabbit groups at any MAP level. AoPWV showed only a slight but significant increase in the young KHC rabbits at different MAP levels, which was mainly due to the increased h/D m . AoPWV could underestimate aortic stiffness due to early to moderate atherosclerosis if AoPWV was adjusted for arterial pressure level.

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Subclinical atherosclerosis is increased in type 2 diabetic patients with microalbuminuria evaluated by intima-media thickness and pulse wave velocity

Cited by 135 publications

References 40 publications

Arterial Stiffness in Mild-to-Moderate CKD

Arterial Stiffness in Mild-to-Moderate CKD

Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease

To what extent does aortic pulse wave velocity estimate early atherosclerosis in Kurosawa and Kusanagi-hypercholesterolemic rabbits?

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