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Title: Correlates of aortic stiffness progression in patients with type 2 diabetes: importance of glycemic control
Authors: Ferreira, Marcel T.
Leite, Nathalie C.
Cardoso, Claudia R.L.
Salles, Gil F.
Affilliation: Sem afiliação.
Sem afiliação.
Sem afiliação.
Universidade Federal do Rio de Janeiro. University Hospital Clementino Fraga Filho. Rio de Janeiro, RJ, Brazil / Universidade Federal do Rio de Janeiro. School of Medicine. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil .
Abstract: OBJECTIVE: The correlates of serial changes in aortic stiffness in patients with diabetes have never been investigated. We aimed to examine the importance of glycemic control on progression/regression of carotid-femoral pulse wave velocity (cf-PWV) in type 2 diabetes. RESEARCH DESIGN AND METHODS: In a prospective study, two cf-PWV measurements were performed with the Complior equipment in 417 patients with type 2 diabetes over a mean follow-up of 4.2 years. Clinical laboratory data were obtained at baseline and throughout follow-up. Multivariable linear/logistic regressions assessed the independent correlates of changes in cf-PWV. RESULTS: Median cf-PWV increase was 0.11 m/s per year (1.1% per year). Overall, 212 patients (51%) increased/persisted with high cf-PWV, while 205 (49%) reduced/persisted with low cf-PWV. Multivariate linear regression demonstrated direct associations between cf-PWV changes and mean HbA1c during follow-up (partial correlation 0.14, P = 0.005). On logistic regression, a mean HbA1c ‡7.5% (58 mmol/mol) was associated with twofold higher odds of having increased/persistently high cf-PWV during follow-up. Furthermore, the rate of HbA1c reduction relative to baseline levels was inversely associated with cf-PWV changes (partial correlation 20.11, P = 0.011) and associated with reduced risk of having increased/persistently high aortic stiffness (odds ratio 0.82 [95% CI 0.69–0.96]; P = 0.017). Other independent correlates of progression in aortic stiffness were increases in systolic blood pressure and heart rate between the two cf-PWV measurements, older age, female sex, and presence of dyslipidemia and retinopathy. CONCLUSIONS: Better glycemic control, together with reductions in blood pressure and heart rate,was themost important correlate to attenuate/prevent progression of aortic stiffness in patients with type 2 diabetes.
Keywords: Diabetes
Type 2 diabetes
Aortic stiffness
Glycemic control
Issue Date: 2015
Publisher: American Diabetes Association
Citation: FERREIRA, Marcel T. et al. Correlates of aortic stiffness progression in patients with type 2 diabetes: importance of glycemic control: the Rio de Janeiro type 2 diabetes cohort study. Diabetes Care, v. 38, p. 897-904, May 2015.
Description: Marcel T. Ferreira. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.
DOI: 10.2337/dc14-2791
ISSN: 0149-5992
Copyright: restricted access
Appears in Collections:INI - Artigos de Periódicos

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