Vascular or chronological age: which is the better marker to estimate the cardiovascular risk in patients with type 1 diabetes?

Andrade, Carolina Barbosa de; Silva, Eliete Leão Clemente; Matta, Maria de Fátima Bevilaqua da; Castier, Márcia Bueno; Rosa, Maria Luiza Garcia; Gomes, Marı́lia B.

doi:10.1007/s00592-016-0891-8

Cited by 6 publications

(7 citation statements)

References 31 publications

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Section: Vascular Agingmentioning

confidence: 99%

“…6 Vascular age is a better predictor of CV risk than chronological age when studying patients with type 1 diabetes and for death when studying patients with chronic kidney disease. 7,8 Disconcordance between vascular and chronological age might mean two things: either a person is in better vascular health than his peers of the same sex or the oppositetheir vascular health is worse than their peers of the same sex. For example, vascular age much higher than chronological age implies early vascular aging (EVA).…”

Section: Concepts Of Early Vascular Aging and Supernormal Vascular Agingmentioning

confidence: 99%

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Vascular Aging and COVID-19

Badaras

Laučytė-Cibulskienė

2022

Angiology

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Vascular age is determined by functional and structural changes in the arterial wall. When measured by its proxy, pulse wave velocity, it has been shown to predict cardiovascular and total mortality. Disconcordance between chronological and vascular age might represent better or worse vascular health. Cell senescence is caused by oxidative stress and sustained cell replication. Senescent cells acquire senescence-associated secretory phenotype. Oxidative stress, endothelial dysfunction, dysregulation of coagulation and leucocyte infiltration are observed in the aging endothelium. All of these mechanisms lead to increased vascular calcification and stiffness. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can involve the vascular endothelium. It enters cells using angiotensin-converting enzyme 2 (ACE-2) receptors, which are abundant in endothelial cells. The damage this virus does to the endothelium can be direct or indirect. Indirect damage is caused by hyperinflammation. Direct damage results from effects on ACE-2 receptors. The reduction of ACE-2 levels seen during coronavirus disease 2019 (COVID-19) infection might cause vasoconstriction and oxidative stress. COVID-19 and vascular aging share some pathways. Due to the novelty of the virus, there is an urgent need for studies that investigate its long-term effects on vascular health.

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Section: Vascular Agingmentioning

confidence: 99%

Section: Concepts Of Early Vascular Aging and Supernormal Vascular Agingmentioning

confidence: 99%

Vascular Aging and COVID-19

Badaras

Laučytė-Cibulskienė

2022

Angiology

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“…In these studies, the increase in CIMT was associated with a higher incidence of cardiovascular events in the background populations and in patients with DM. Even in patients with type 1 diabetes, the use of VA age may contribute to the identification of high CVR, 27 although the course of cardiovascular disease is different when compared to T2DM. However, there are controversies in studies that use CIMT for detection of subclinical atherosclerosis.…”

Section: Overview Of Demographic and Laboratory Data Of The Studied Pmentioning

confidence: 99%

<p>Vascular Age as a Cardiovascular Risk Marker in Asymptomatic Patients with Type 2 Diabetes</p>

Palma¹,

Lopes²,

Silva³

et al. 2020

DMSO

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Aim: There is a wide variety of cardiovascular outcomes in patients with type 2 diabetes (T2DM), even in asymptomatic individuals. Carotid intima-media thickness (CIMT) is a marker of subclinical atherosclerosis and can be considered as a predictor of cardiovascular risk (CVR). The aim of this study was to evaluate the relationship between CIMT-determined vascular age (VA), CVR scores, and thyroid function in asymptomatic patients with T2DM. Patients and Methods: Clinical laboratory and CIMT parameters were measured in 154 asymptomatic patients with T2DM. The Framingham risk score (FRS) was performed with chronological age (CA) and with VA. A multinomial logistic regression model was used to analyze variables related to CVR reclassification. Results: The use of CIMT-determined VA led to the reclassification of 54 (35.52%) out of 152 asymptomatic T2DM patients, being 20 (37.03%) to a lower categorical risk and 34 (62.96%) to a higher categorical risk according to FRS. The variables that were associated to reclassification to a higher categorical risk were positive family history (FH) of premature coronary artery disease (p=0.046), FH of thyroid disease (p=0.010), use of statins (p=0.027), and free T4 levels (p=0.009). Conclusion: VA determined from CIMT allowed the reclassification of the CVR in asymptomatic T2DM patients. FH of premature CAD, FH of known thyroid disease, use of statins, and free T4 levels were associated to a reclassification into a higher risk category. The use of doppler to perform CIMT measure is currently more accessible, especially in a low-middle income country like Brazil. However, further prospective studies must be performed to establish the predictive values of CIMT on atherosclerosis and how thyroid function acts like cardiovascular risk marker on CVR scores.

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“…People with T1DM have an increased VA, a marker of subclinical atherosclerosis. The use of VA may contribute to the identi cation of high CVD risk in T1DM [15].…”

Section: Introductionmentioning

confidence: 99%

Vascular age and arterial stiffness in the assessment of cardiovascular risk among young adults with type 1 diabetes.

Naskret,

Kulecki,

Kaminski

et al. 2023

Preprint

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Background Cardiovascular risk (CVR) in people with T1DM is assessed using ESC/EASD criteria. However, recent studies have suggested methods that are more accurate for T1DM, such as the Steno Type 1 Risk Engine (ST1RE), vascular age (VA) based on common carotid intima-media thickness (cIMT), and arterial stiffness (AS). We aimed to investigate the association between VA, AS, ST1RE, and ESC/EASD 2019 CVR categories in people with T1DM. Methods The study group comprised T1DM adults aged 18–45 years with a diabetes duration of at least 5 years and without cardiovascular disease. Medical history, anthropometrical features, and laboratory results were collected and used to calculate the 10-year CVR using ST1RE. The cIMT automatic measurement was performed. Based on cIMT, VA was calculated and used instead of chronological age to estimate the modified ST1RE score. We assessed AS by measuring the 24-hour aortic pulse wave velocity (PWV Ao) with a brachial oscillometric device (Arteriograph 24). The participants were divided into 3 CVR categories using ESC/EASD criteria and modified ST1RE scores. Results Sixty-one individuals with a median age of 30.0 (25.0–36.0) years and a diabetes duration of 15.0 (9.0–20.0) years were enrolled. PWV Ao was positively related to VA (Rs = 0.31; p = 0.01) and the modified ST1RE score (Rs = 0.36; p < 0.01). Modified ST1RE categories showed significantly higher agreement (κ = 0.14; p = 0.02) with the ESC/EASD 2019 criteria than the standard ST1RE (κ = 0.00; p = 0.92). The PWV Ao increased with each ESC/EASD 2019 category – 6.62 (6.51–7.32) m/s at moderate risk, 7.50 (7.00–8.05) m/s at high risk, and 8.33 (7.52–9.21) m/s at very high risk (p = 0.02). The multiple logistic regression model revealed that PWV Ao was positively associated with high versus low and moderate CVR based on modified ST1RE (OR = 2.58; 95% CI: 1.04–6.42; p = 0.04). The association was independent of sex, glycated hemoglobin, diabetes duration, the presence of diabetic complications, and BMI. Conclusions Among individuals with T1DM, AS and VA are positively associated with ESC/EASD 2019 criteria and both ST1RE scores. CVR categories based on ST1RE with vascular instead of chronological age have better agreement with the ESC/EASD 2019 criteria.

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Vascular or chronological age: which is the better marker to estimate the cardiovascular risk in patients with type 1 diabetes?

Abstract: T1D patients have an increased VA, a marker of subclinical atherosclerosis. The use of VA age may contribute to the identification of high CVD risk in T1D. In patients with T1D, a younger chronological age, particularly in women, might not be a protective factor for CVD.

Cited by 6 publications

References 31 publications

Vascular Aging and COVID-19

Vascular Aging and COVID-19

<p>Vascular Age as a Cardiovascular Risk Marker in Asymptomatic Patients with Type 2 Diabetes</p>

Vascular age and arterial stiffness in the assessment of cardiovascular risk among young adults with type 1 diabetes.

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