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Mashaba RG, Phoswa W, Maimela E, Lebelo S, Modjadji P, Mokgalaboni K. Systematic review and meta-analysis assessing the status of carotid intima-media thickness and lipid profiles in type 2 diabetes mellitus. BMJ Open 2024; 14:e087496. [PMID: 39521468 PMCID: PMC11552583 DOI: 10.1136/bmjopen-2024-087496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 09/27/2024] [Indexed: 11/16/2024] Open
Abstract
OBJECTIVES Carotid intima-media thickness (CIMT) is a measurement for subclinical atherosclerosis and has been associated with overall cardiovascular diseases, especially in type 2 diabetes mellitus (T2DM). We aimed to assess the status of carotid health and lipid profile in T2DM. DESIGN This systematic review and meta-analysis synthesised data published from clinical studies. DATA SOURCES Google Scholar, PubMed and Scopus were searched from inception to 18 January 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies conducted in patients with T2DM and those without T2DM were included. Studies conducted in T2DM adults evaluating carotid status and lipid profile were considered. DATA EXTRACTION AND SYNTHESIS Two authors independently used standardised methods to comprehensively search, screen and extract data from all relevant studies. The risk of bias was assessed using the Newcastle-Ottawa checklist. Meta-analysis was conducted using Review Manager and metaHun through random effects models. The random effect model was used due to high heterogeneity. RESULTS Evidence was analysed from 57 studies with a sample size of 29 502 (8254 T2DM and 21 248 people without T2DM). There was a significantly higher CIMT, with a standardised mean difference (SMD) of 1.01 (95% CI 0.75, 1.26, p<0.00001). Additionally, there was an elevated triglyceride (TG) (SMD=1.12, 95% CI 0.82, 1.41, p<0.00001), total cholesterol (TC), (SMD=0.24, 95% CI 0.02, 0.46, p=0.03) and low-density lipoprotein-cholesterol (LDL-C), (SMD=0.35, 95% CI 0.11, 0.59, p=0.004) in patients with T2DM compared with those without T2DM. Furthermore, a significant decrease in high-density lipoprotein cholesterol (HDL-C) was observed in the T2DM compared with people without T2DM, SMD=-0.79, 95% CI -0.96, -0.62, p<0.00001). Age, body mass index and hypertension were associated with increased CIMT and TG and decreased HDL-C in T2DM. Additionally, age, gender and hypertension were associated with an increased LDL-C in T2DM. CONCLUSION Our findings suggest that an increased CIMT is accompanied by increased TG, TC, LDL-C and HDL-C reduction in patients with T2DM. PROSPERO REGISTRATION NUMBER CRD42023451731.
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Affiliation(s)
- Reneilwe Given Mashaba
- Life and Consumer Sciences, University of South Africa College of Agriculture and Environmental Sciences, Florida, Gauteng, South Africa
- DIMAMO Population Health Research Centre, University of Limpopo - Turfloop Campus, Mankweng, South Africa
| | - Wendy Phoswa
- Life and Consumer Sciences, University of South Africa College of Agriculture and Environmental Sciences, Florida, Gauteng, South Africa
| | - Eric Maimela
- DIMAMO Population Health Research Centre, University of Limpopo - Turfloop Campus, Mankweng, South Africa
| | - Sogolo Lebelo
- Life and Consumer Sciences, University of South Africa College of Agriculture and Environmental Sciences, Florida, Gauteng, South Africa
| | - Perpetua Modjadji
- Life and Consumer Sciences, University of South Africa College of Agriculture and Environmental Sciences, Florida, Gauteng, South Africa
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
| | - Kabelo Mokgalaboni
- Life and Consumer Sciences, University of South Africa College of Agriculture and Environmental Sciences, Florida, Gauteng, South Africa
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Kaufmann CC, Breyer MK, Hartl S, Gross C, Schiffers C, Wouters EFM, Breyer-Kohansal R, Weber T, Huber K, Agusti A, Burghuber OC. Association of Preserved Ratio Impaired Spirometry with Arterial Stiffness. Ann Am Thorac Soc 2024; 21:1289-1298. [PMID: 38820245 DOI: 10.1513/annalsats.202310-859oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 05/23/2024] [Indexed: 06/02/2024] Open
Abstract
Rationale: Preserved ratio impaired spirometry (PRISm) is a recently recognized spirometric pattern defined by a ratio of forced expiratory volume in 1 second to forced vital capacity of at least 0.70 and a forced expiratory volume in 1 second <80% of reference. For unclear reasons, PRISm is associated with increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is a major mechanism of CV disease, which can be measured by carotid-femoral pulse-wave velocity (cfPWV). Objectives: We explored the hypothesis that cfPWV would be increased in individuals with PRISm and airflow limitation (AL). Methods: We measured forced spirometry, lung volumes by body plethysmography, and cfPWV in 9,466 subjects recruited from the general population in the Austrian cross-sectional LEAD (Lung, Heart, Social, Body) study and tested the association of arterial stiffness with PRISm and AL by multivariable linear regression analysis. Individuals younger than 18 years were excluded from the study. Results: Individuals with PRISm (n = 431; 4.6%) were of similar age to those with normal spirometry (n = 8,136; 85.9%) and significantly younger than those with AL (n = 899; 9.5%). Arterial hypertension, diabetes mellitus, coronary artery disease, heart failure, and peripheral arterial occlusive disease were significantly more common in individuals with PRISm than in those with normal lung function and similar to those with AL. There was a significant association between PRISm and arterial stiffness on bivariate linear regression analysis (crude model, β = 0.038; 95% confidence interval [CI], 0.016-0.058), which persisted after robust adjustment for clinical confounders upon multivariable analysis (final model, β = 0.017; 95% CI, 0.001-0.032). cfPWV was significantly higher in individuals with PRISm irrespective of the presence of established CV disease or pulmonary restriction. AL also showed a significant association with arterial stiffness on multivariable linear regression analysis (final model, β = 0.025; 95% CI, 0.009-0.042). Conclusions: Arterial stiffness measured by cfPWV is increased in individuals with PRISm independent of CV disease and risk factors. The pathobiological mechanisms underlying this association deserve further research.
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Affiliation(s)
- Christoph C Kaufmann
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Clinic Penzing, and
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | | | | | - Emiel F M Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria
| | - Thomas Weber
- Department of Cardiology, Klinikum Wels-Grieskirchen, Wels, Austria; and
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Alvar Agusti
- Catedra Salud Respiratoria, Universidad de Barcelona, Clinic Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
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Roca F, Zmuda L, Noël G, Duflot T, Iacob M, Moreau-Grangé L, Prévost G, Joannides R, Bellien J. Changes in carotid arterial wall viscosity and carotid arterial stiffness in type 2 diabetes patients. Atherosclerosis 2024; 394:117188. [PMID: 37532594 DOI: 10.1016/j.atherosclerosis.2023.117188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND AND AIMS Changes in arterial wall viscosity (AWW) and stiffness during type 2 diabetes (T2D) have been little investigated. We explored changes in carotid AWV considering change in arterial stiffness and loading conditions, in patients with T2D. METHODS This cross-sectional, monocentric study compared 19 middle-aged patients with T2D to 30 non-diabetic (ND) controls. The absolute viscosity (WV) was determined as the area of the pressure-lumen cross-sectional area (P-LCSA) loop obtained by carotid tonometry and contralateral echo-tracking. The relative viscosity was determined as the ratio between WV and the elastic energy stored within the arterial wall (WV/WE). Carotid geometry, midwall stress, distensibility and elastic modulus were also compared between groups. RESULTS T2D patients were older and more frequently had hypertension. Internal diameter, mean central and pulse blood pressure were higher in T2D patients but midwall stress was similar compared to ND controls. WV and WV/WE were higher in T2D patients when compared with ND controls (23 [16-41] vs. 11 [7-18] mm Hg.mm2, p=0.007 and 21% [17-25] vs. 12% [8-17], p < 0.001 respectively) even after adjustment on confounding factors. Carotid arterial stiffness was higher in T2D patients, but after adjustment this difference was only observed for the highest levels of midwall stress. CONCLUSIONS Carotid AWV and stiffness are increased in T2D patients but only AWV is significantly increased after considering loading conditions. Whether this increase in energy dissipation within the arterial wall contributes to alter cardiovascular coupling in T2D remains to be established.
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Affiliation(s)
- Frédéric Roca
- Normandy University, UniRouen, Inserm UMR1096 EnVI, FHU REMOD-VHF, F-76000, Rouen, France; Department of Pharmacology, Rouen University Hospital, F-76000, Rouen, France; Department of Geriatric Medicine, Rouen University Hospital, F 76000, Rouen, France.
| | - Louise Zmuda
- Department of Pharmacology, Rouen University Hospital, F-76000, Rouen, France; Department of Geriatric Medicine, Rouen University Hospital, F 76000, Rouen, France
| | - Gabrielle Noël
- Department of Pharmacology, Rouen University Hospital, F-76000, Rouen, France; Department of Geriatric Medicine, Rouen University Hospital, F 76000, Rouen, France
| | - Thomas Duflot
- Normandy University, UniRouen, Inserm UMR1096 EnVI, FHU REMOD-VHF, F-76000, Rouen, France; Department of Pharmacology, Rouen University Hospital, F-76000, Rouen, France
| | - Michèle Iacob
- Department of Pharmacology, Rouen University Hospital, F-76000, Rouen, France
| | - Lucile Moreau-Grangé
- Department of Endocrinology, Diabetes and Metabolic Diseases, Normandie Univ, UNIROUEN, Rouen University Hospital, F 76000, Rouen, France
| | - Gaëtan Prévost
- Department of Endocrinology, Diabetes and Metabolic Diseases, Normandie Univ, UNIROUEN, Rouen University Hospital, F 76000, Rouen, France; CIC-CRB U1404, CHU Rouen, F-76000, Rouen, France
| | - Robinson Joannides
- Normandy University, UniRouen, Inserm UMR1096 EnVI, FHU REMOD-VHF, F-76000, Rouen, France; Department of Pharmacology, Rouen University Hospital, F-76000, Rouen, France; CIC-CRB U1404, CHU Rouen, F-76000, Rouen, France
| | - Jeremy Bellien
- Normandy University, UniRouen, Inserm UMR1096 EnVI, FHU REMOD-VHF, F-76000, Rouen, France; Department of Pharmacology, Rouen University Hospital, F-76000, Rouen, France; CIC-CRB U1404, CHU Rouen, F-76000, Rouen, France
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Liao CK, Lin SK, Hsiu H. Assessing the severity of AstraZeneca COVID-19 vaccine-related side effects through pulse spectrum analysis. Medicine (Baltimore) 2024; 103:e37132. [PMID: 38335378 PMCID: PMC10860989 DOI: 10.1097/md.0000000000037132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
AstraZeneca (AZ) vaccine is one of the most common vaccines against COVID-19 used globally. However, adverse reactions post-vaccination have been reported, including severe symptoms and cases of sudden death within several hours. Therefore, this study aimed to establish a database of spectral characteristics of blood pressure waveforms (BPWs) for the AZ vaccine and analyze reactions after vaccine administration using objective physiological signal and symptom analyses for identifying potential differences between heavy and slight groups defined in the study. In total, 24 participants were enrolled in the case-control study. BPW measurements were acquired pre- and post-vaccination. A questionnaire survey on side effects was conducted 5 days after vaccination. The related spectral characteristics of heavy and slight groups were acquired after Fourier transform analysis. Four types of harmonic indexes from BPW signals, including amplitude proportion (Cn), coefficient of variation of Cn (CVn), phase angle (Pn), and standard deviation of Pn (Pn_SD), were derived. The characteristics of harmonic indexes of arterial BPW for the AZ vaccine were in C6 (P = .011), CV2 (P = .027), P5 (P = .009), and P2_SD (P = .027) on the radial pulse. C5 (P = .037), C8 (P = .007), C9 (P = .037), CV5 (P = .015), CV8 (P = .005), and CV9 (P = .028) were significantly different at posttest between heavy and slight groups. In both pretest or posttest, C8 was almost significantly different between slight and heavy groups. More parameters changed significantly post-vaccination, with more severe side effects. Most average values of posttest/pretest of CVn and Pn_SD in the slight group exceeded 100%. All average values of posttest/pretest of CVn and Pn_SD in the heavy group were smaller than 100%. This approach may enable prediction of the risk of reactions post-vaccination to determine suitability of the AZ vaccine and evaluation of side effect severity in vaccinated individuals using pulse analysis to ensure relevant precautions are taken.
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Affiliation(s)
- Chen-Kai Liao
- Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Shun-Ku Lin
- Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsin Hsiu
- Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
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Tang CC, Tsai JP, Chen YH, Hung SC, Lin YL, Hsu BG. Associations of Glucometabolic Indices with Aortic Stiffness in Patients Undergoing Peritoneal Dialysis with and without Diabetes Mellitus. Int J Mol Sci 2023; 24:17094. [PMID: 38069423 PMCID: PMC10707165 DOI: 10.3390/ijms242317094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/28/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
Disruptions in glucose metabolism are frequently observed among patients undergoing peritoneal dialysis (PD) who utilize glucose-containing dialysis solutions. We aimed to investigate the relationship between glucometabolic indices, including fasting glucose, insulin resistance, advanced glycation end products (AGEs), PD-related glucose load, and icodextrin usage, and aortic stiffness in PD patients with and without diabetic mellitus (DM). This study involved 172 PD patients (mean age 58.3 ± 13.5 years), consisting of 110 patients without DM and 62 patients with DM. Aortic stiffness was assessed using the carotid-femoral pulse wave velocity (cfPWV). Impaired fasting glucose was defined as a fasting glucose level ≥ 100 mg/dL. Homeostatic model assessment for insulin resistance (HOMA-IR) scores, serum AGEs, dialysate glucose load, and icodextrin usage were assessed. Patients with DM exhibited the highest cfPWV (9.9 ± 1.9 m/s), followed by those with impaired fasting glucose (9.1 ± 1.4 m/s), whereas patients with normal fasting glucose had the lowest cfPWV (8.3 ± 1.3 m/s), which demonstrated a significant trend. In non-DM patients, impaired fasting glucose (β = 0.52, 95% confidence interval [CI] = 0.01-1.03, p = 0.046), high HOMA-IR (β = 0.60, 95% CI = 0.12-1.08, p = 0.015), and a high PD glucose load (β = 0.58, 95% CI = 0.08-1.08, p = 0.023) were independently associated with increased cfPWV. In contrast, none of the glucometabolic factors contributed to differences in cfPWV in DM patients. In conclusion, among PD patients without DM, impaired fasting glucose, insulin resistance, and PD glucose load were closely associated with aortic stiffness.
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Affiliation(s)
- Chi-Chong Tang
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan;
- Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan
| | - Jen-Pi Tsai
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; (J.-P.T.); (S.-C.H.)
- Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
| | - Yi-Hsin Chen
- Division of Nephrology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan;
| | - Szu-Chun Hung
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; (J.-P.T.); (S.-C.H.)
- Division of Nephrology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 23142, Taiwan
| | - Yu-Li Lin
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan;
- Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; (J.-P.T.); (S.-C.H.)
| | - Bang-Gee Hsu
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan;
- Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; (J.-P.T.); (S.-C.H.)
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Tai YL, Marupudi S, Figueroa GA, Russell RD. Hemodynamics and Arterial Stiffness in Response to Oral Glucose Loading in Individuals with Type II Diabetes and Controlled Hypertension. High Blood Press Cardiovasc Prev 2023; 30:175-181. [PMID: 36913100 DOI: 10.1007/s40292-023-00569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/21/2023] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION Type 2 diabetes (T2D), the fastest growing pandemic, is typically accompanied by vascular complications. A central hallmark of both T2D and vascular disease is insulin resistance which causes impaired glucose transport and vasoconstriction concomitantly. Those with cardiometabolic disease display greater variation in central hemodynamics and arterial elasticity, both potent predictors of cardiovascular morbidity and mortality, which may be exacerbated by concomitant hyperglycemia and hyperinsulinemia during glucose testing. Thus, elucidating central and arterial responses to glucose testing in those with T2D may identify acute vascular pathophysiologies triggered by oral glucose loading. AIM This study compared hemodynamics and arterial stiffness to an oral glucose challenge (OGC: 50g glucose) between individuals with and without T2D. 21 healthy (48 ± 10 years) and 20 participants with clinically diagnosed T2D and controlled hypertension (52 ± 8 years) were tested. METHODS Hemodynamics and arterial compliance were assessed at baseline, and 10, 20, 30, 40, 50, and 60 min post-OGC. RESULTS Heart rate increased between 20 and 60 post-OGC in both groups (p < 0.05). Central systolic blood pressure (SBP) decreased in the T2D group between 10 and 50 min post-OGC while central diastolic blood pressure (DBP) decreased in both groups from 20 to 60 post-OGC. Central SBP decreased in T2D between 10 and 50 min post-OGC and central DBP decreased in both groups between 20 and 60 min post-OGC. Brachial SBP decreased between 10 and 50 min in healthy participants, whereas both groups displayed decreases in brachial DBP between 20 and 60 min post-OGC. Arterial stiffness was unaffected. CONCLUSIONS An OGC alters central and peripheral blood pressure in healthy and T2D participants similarly with no changes in arterial stiffness.
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Affiliation(s)
- Yu Lun Tai
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Smaran Marupudi
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Gabriel A Figueroa
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Ryan D Russell
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA.
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Nibali L, Gkranias N, Mainas G, Di Pino A. Periodontitis and implant complications in diabetes. Periodontol 2000 2022; 90:88-105. [PMID: 35913467 DOI: 10.1111/prd.12451] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Epidemiologic evidence indicates that periodontitis is more frequent in patients with uncontrolled diabetes mellitus than in healthy controls, suggesting that it could be considered the "sixth complication" of diabetes. Actually, diabetes mellitus and periodontitis are two extraordinarily prevalent chronic diseases that share a number of comorbidities all converging toward an increased risk of cardiovascular disease. Periodontal treatment has recently been shown to have the potential to improve the metabolic control of diabetes, although long-term studies are lacking. Uncontrolled diabetes also seems to affect the response to periodontal treatment, as well as the risk to develop peri-implant diseases. Mechanisms of associations between diabetes mellitus and periodontal disease include the release of advanced glycation end products as a result of hyperglycemia and a range of shared predisposing factors of genetic, microbial, and lifestyle nature. This review discusses the evidence for the risk of periodontal and peri-implant disease in diabetic patients and the potential role of the dental professional in the diabetes-periodontal interface.
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Affiliation(s)
- Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Nikolaos Gkranias
- Centre for Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University London (QMUL), London, UK
| | - Giuseppe Mainas
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Hirowatari Y, Yanai H. Association of atherogenic serum lipids and platelet activation with changes in arterial stiffness in patients with type 2 diabetes. GHM OPEN 2022; 2:31-37. [PMID: 40144711 PMCID: PMC11933956 DOI: 10.35772/ghmo.2021.01028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/28/2021] [Accepted: 12/28/2021] [Indexed: 03/28/2025]
Abstract
Pulse wave velocity (PWV) is a potential marker for atherosclerosis severity and/or predictor of future atherosclerotic cardiovascular events. PWV is significantly correlated with carotid-intimal media thickness in patients with diabetes. However, its significance as a surrogate marker for the treatment of atherosclerotic cardiovascular risk in the management of type 2 diabetes has not been fully established. To elucidate the factors that determine the improvement or deterioration of PWV, we studied the association of clinical parameters, parameters for glucose metabolism, serum lipids including each lipoprotein fraction, serotonin as a marker for platelet activation, and change in PWV in 54 patients with type 2 diabetes. Systolic blood pressure and serum levels of non-high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol (LDL-C), and intermediate-density lipoprotein-cholesterol significantly decreased in the PWV-improved group after 2 months compared with those in the PWV-deteriorated group. The serotonin levels at baseline were significantly lower in the PWV-improved group than in the PWV-deteriorated group. The changes in systolic blood pressure and LDL-C levels were significantly and positively correlated with those in PWV. The serotonin levels at baseline were significantly and positively correlated with changes in PWV. Therefore, amelioration of blood pressure, serum lipid level, and platelet activation might be beneficially associated with PWV change. PWV-guided clinical practice for cardiovascular risk stratification could be useful in type 2 diabetes management.
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Affiliation(s)
- Yuji Hirowatari
- Laboratory Sciences, Department of Health Sciences, Saitama Prefectural University, Saitama, Japan
| | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology, and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
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He D, Gao L, Yang Y, Jia J, Jiang Y, Sun P, Liu B, Li J, Fan F, Zhang Y, Huo Y. Brachial-ankle pulse wave velocity as a measurement for increased carotid intima-media thickness: A comparison with carotid-femoral pulse wave velocity in a Chinese community-based cohort. J Clin Hypertens (Greenwich) 2022; 24:409-417. [PMID: 35213771 PMCID: PMC8989757 DOI: 10.1111/jch.14448] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 01/02/2023]
Abstract
Carotid‐femoral pulse wave velocity (cfPWV) and brachial‐ankle pulse wave velocity (baPWV) act as two most frequently applied indicators to evaluate arterial stiffness. Limited studies have systematically compared the relationships between cfPWV/baPWV and increased carotid intima‐media thickness (cIMT). This study aimed to investigate the associations of the two PWV indices with cIMT in a Chinese community‐based population. A total of 6026 Chinese participants from an atherosclerosis cohort were included in our analysis. Increased cIMT was defined as the maximum of cIMT > 0.9 mm in end‐systolic period of carotid artery. Mean (SD) cfPWV and baPWV were 8.55±1.83 and 16.79±3.35 m/s, respectively. The prevalence of increased cIMT was 59.58%. In multivariable logistic regression, both PWVs were independently associated with increased cIMT after adjustment for various confounders (for 1 m/s increase of cfPWV: OR = 1.07, 95% CI: 1.02‐1.11; for 1 m/s increase of baPWV: OR = 1.03, 95% CI: 1.00‐1.05). The highest cfPWV and baPWV quartile groups had higher prevalence of increased cIMT when compared with the lowest quartile groups (for cfPWV: OR = 1.28, 95% CI: 1.06‐1.55; for baPWV: OR = 1.23, 95% CI: 1.00‐1.50). However, when both PWVs were added into multivariable model simultaneously, only cfPWV was associated with odds of increased cIMT. Subgroup analyses further showed cfPWV was more strongly associated with increased cIMT than baPWV in males, participants aged ≥65 years, and those with other cardiovascular risk factors. In conclusion, both cfPWV and baPWV are associated with increased cIMT in a Chinese community‐based population. Furthermore, cfPWV is more strongly correlated with increased cIMT compared to baPWV.
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Affiliation(s)
- Danmei He
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Lan Gao
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ying Yang
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yimeng Jiang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Pengfei Sun
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Bo Liu
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
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10
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Alghamdi YA, Al-Shahrani FS, Alanazi SS, Alshammari FA, Alkhudair AM, Jatoi NA. The Association of Blood Glucose Levels and Arterial Stiffness (Cardio-Ankle Vascular Index) in Patients With Type 2 Diabetes Mellitus. Cureus 2021; 13:e20408. [PMID: 34926096 PMCID: PMC8671052 DOI: 10.7759/cureus.20408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Diabetes mellitus causes a major burden on healthcare systems all around the world. It has been documented that type 2 diabetes mellitus (T2DM) is associated with long-term vascular complications including micro-vascular, macro-vascular, and mixed-vascular disorders. Several studies have concluded that the increment of arterial wall stiffness is correlated with an increase in the risk of cardiovascular adverse events and the mortality associated with it. AIMS This study purposed to evaluate the arterial stiffness measurements, using Cardio-Ankle Vascular Index (CAVI), in T2DM patients, and the relationship with the fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and other factors that may increase the risk of elevated arterial stiffness in T2DM patients. METHODOLOGY A total of 200 patients were recruited from the outpatient setting at King Fahd Hospital of the University, Al Khobar. A total of 181 patients fit the inclusion criteria. The charts of the patients who fit the inclusion criteria were reviewed and data related to age, gender, body mass index, smoking history, FBG, HbA1c levels, blood pressure (mmHg) measurements, and CAVI scores were collected. RESULTS The elevation in CAVI readings was noted to be more prominent in the senior age group. Hypertensive patients also showed a significant increase in CAVI readings. In addition, higher CAVI readings were more associated with the male gender rather than females. All of which showed a significant correlation. Furthermore, although it was not significant, higher FBG levels and HbA1c readings were correlated with higher CAVI readings. CONCLUSION The results of the study suggest that factors like age, smoking status, gender, and the increase in blood pressure as well as the increase in blood glucose levels are correlated with higher CAVI readings in T2DM patients. This demonstrates their important effect on arterial wall stiffness while showing that CAVI can be used in predicting the prognosis of arterial wall health in patients with diabetes.
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Affiliation(s)
- Yazid A Alghamdi
- Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, SAU
| | - Faisal S Al-Shahrani
- Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, SAU
| | - Saif S Alanazi
- Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, SAU
| | - Fahad A Alshammari
- Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, SAU
| | - Abdullah M Alkhudair
- Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, SAU
| | - Noor-Ahmed Jatoi
- Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, SAU
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11
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Di Pino A, Scicali R, Marchisello S, Zanoli L, Ferrara V, Urbano F, Filippello A, Di Mauro S, Scamporrino A, Piro S, Castellino P, Purrello F, Rabuazzo AM. High glomerular filtration rate is associated with impaired arterial stiffness and subendocardial viability ratio in prediabetic subjects. Nutr Metab Cardiovasc Dis 2021; 31:3393-3400. [PMID: 34625357 DOI: 10.1016/j.numecd.2021.08.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/08/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS High glomerular filtration rate (HGFR) is associated with cardiovascular damage in the setting of various conditions such as obesity and diabetes. Prediabetes was also associated with increased GFR, however, the association between prediabetes, HGFR and cardiovascular damage has not been investigated. In this study, we investigated the association between HGFR and early markers of cardiovascular disease in subjects with prediabetes. METHODS AND RESULTS Augmentation pressure (Aug), augmentation index (AIx), subendocardial viability ratio (SEVR), pulse wave velocity (PWV), intima-media thickness (IMT) and estimated GFR (eGFR) were evaluated in 230 subjects with prediabetes. The eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration formula. HGFR was defined as an eGFR above the 75th percentile. Prediabetic subjects were divided into two groups according to presence/absence of HGFR: 61 subjects with HGFR and 169 subjects without HGFR. Subjects with HGFR showed higher Aug, AIx and lower SEVR compared with prediabetic subjects with lower eGFR (14.1 ± 7.2 vs 10.8 ± 6.2, 32.9 ± 12.7 vs 27.6 ± 11.7, 153.5 ± 27.8 vs 162 ± 30.2, p < 0.05). No differences were found in PWV and IMT values between the two groups. Then, we performed multiple regression analysis to test the relationship between Aug, SEVR and several cardiovascular risk factors. In multiple regression analysis Aug was associated with age, systolic blood pressure (BP), HOMA-IR and eGFR; the major determinants of SEVR were systolic BP, HOMA-IR and eGFR. CONCLUSION Subjects with prediabetes and HGFR exhibited an increased Aug, AIx and a reduced SEVR. These alterations are associated with eGFR, insulin resistance and systolic BP.
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Affiliation(s)
- Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Simona Marchisello
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Viviana Ferrara
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Francesca Urbano
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Agnese Filippello
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Stefania Di Mauro
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Alessandra Scamporrino
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy.
| | - Agata M Rabuazzo
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
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12
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An Y, Yang Y, Cao B, Dong H, Li A, Zhao W, Ke J, Zhao D. Increased Arterial Stiffness as a Predictor for Onset and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus. J Diabetes Res 2021; 2021:9124656. [PMID: 34604390 PMCID: PMC8486550 DOI: 10.1155/2021/9124656] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, has been demonstrated to be associated with type 2 diabetes mellitus (T2DM) and its vascular complications. This study was aimed at investigating the correlations of baPWV with both the presence and severity of diabetic retinopathy (DR) at baseline and at exploring the predictive role of baPWV in the new onset/progression of DR in the follow-up analysis. METHODS The prospective cohort study recruited 2,473 Chinese patients with T2DM, of whom 663 participants were finally included in the follow-up analysis. The presence and grading of DR were performed by the modified Early Treatment Diabetic Retinopathy Study. Uni- or multivariate linear and logistic regression models and Cox proportional-hazards regression analysis were conducted. RESULTS Of 2,473 patients with T2DM at baseline, 734 individuals were assessed to have DR and further categorized into 630 with non-sight-threatening DR (NSTDR) and 104 with STDR. In addition to the positive relationship between increased baPWV and the presence of DR, multinominal logistic regression analysis revealed that higher tertiles of baPWV were significantly related to the NSTDR (T2: OR = 1.62 (1.22, 2.15), p < 0.001, and T3: OR = 2.58 (1.86, 3.58), p < 0.001) and STDR group (T3: OR = 3.87 (1.87, 8.02), p < 0.001). During a follow-up (mean period of 16.4 months), 111 participants had new onset/progression of DR. The cox regressions showed that high baseline baPWV was correlated with increased risk of development/progression of DR (HR = 2.24, 95% CI (1.24, 4.03), p = 0.007, for T2 baPWV and HR = 2.90, 95% CI (1.49, 5.64), p = 0.002, for T3 baPWV) after adjustments for multiple factors. CONCLUSIONS Our results demonstrated that baseline baPWV might be an independent predictor in new onset/worsening of DR, suggesting that increased arterial stiffness might be involved in the development of DR. Follow-up studies with a longer duration are needed.
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Affiliation(s)
- Yaxin An
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
| | - Yuxian Yang
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
| | - Bin Cao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
| | - Huan Dong
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
| | - Aihua Li
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
| | - Wenying Zhao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
| | - Jing Ke
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
| | - Dong Zhao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China
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13
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Ramirez-Perez FI, Woodford ML, Morales-Quinones M, Grunewald ZI, Cabral-Amador FJ, Yoshida T, Brenner DA, Manrique-Acevedo C, Martinez-Lemus LA, Chandrasekar B, Padilla J. Mutation of the 5'-untranslated region stem-loop mRNA structure reduces type I collagen deposition and arterial stiffness in male obese mice. Am J Physiol Heart Circ Physiol 2021; 321:H435-H445. [PMID: 34242094 PMCID: PMC8526337 DOI: 10.1152/ajpheart.00076.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Arterial stiffening, a characteristic feature of obesity and type 2 diabetes, contributes to the development and progression of cardiovascular diseases (CVD). Currently, no effective prophylaxis or therapeutics is available to prevent or treat arterial stiffening. A better understanding of the molecular mechanisms underlying arterial stiffening is vital to identify newer targets and strategies to reduce CVD burden. A major contributor to arterial stiffening is increased collagen deposition. In the 5'-untranslated regions of mRNAs encoding for type I collagen, an evolutionally conserved stem-loop (SL) structure plays an essential role in its stability and post-transcriptional regulation. Here, we show that feeding a high-fat/high-sucrose (HFHS) diet for 28 wk increases adiposity, insulin resistance, and blood pressure in male wild-type littermates. Moreover, arterial stiffness, assessed in vivo via aortic pulse wave velocity, and ex vivo using atomic force microscopy in aortic explants or pressure myography in isolated femoral and mesenteric arteries, was also increased in those mice. Notably, all these indices of arterial stiffness, along with collagen type I levels in the vasculature, were reduced in HFHS-fed mice harboring a mutation in the 5'SL structure, relative to wild-type littermates. This protective vascular phenotype in 5'SL-mutant mice did not associate with a reduction in insulin resistance or blood pressure. These findings implicate the 5'SL structure as a putative therapeutic target to prevent or reverse arterial stiffening and CVD associated with obesity and type 2 diabetes.NEW & NOTEWORTHY In the 5'-untranslated (UTR) regions of mRNAs encoding for type I collagen, an evolutionally conserved SL structure plays an essential role in its stability and posttranscriptional regulation. We demonstrate that a mutation of the SL mRNA structure in the 5'-UTR decreases collagen type I deposition and arterial stiffness in obese mice. Targeting this evolutionarily conserved SL structure may hold promise in the management of arterial stiffening and CVD associated with obesity and type 2 diabetes.
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Affiliation(s)
- Francisco I Ramirez-Perez
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, Missouri
| | - Makenzie L Woodford
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | | | - Zachary I Grunewald
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | | | - Tadashi Yoshida
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - David A Brenner
- School of Medicine, University of California-San Diego, La Jolla, California
| | - Camila Manrique-Acevedo
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Division of Endocrinology and Metabolism, Department of Medicine, University of Missouri, Columbia, Missouri.,Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri
| | - Luis A Martinez-Lemus
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, Missouri.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Bysani Chandrasekar
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri.,Division of Cardiovascular Medicine, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Jaume Padilla
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
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14
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Kocayigit I, Atum M, Sahinkus S, Aksoy M, Can Y. Increased cardio-ankle vascular index values in patients with acute branch retinal vein occlusion. Indian J Ophthalmol 2021; 68:868-871. [PMID: 32317466 PMCID: PMC7350491 DOI: 10.4103/ijo.ijo_1300_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: Patients with retinal vein occlusions (RVOs) are at increased risk of cardiovascular disease. Arterial stiffness is an independent risk factor for cardiovascular events. Our aim is to evaluate the arterial stiffness in patients with acute branch retinal vein occlusion (BRVO) by using cardio-ankle vascular index (CAVI). Methods: This prospective study included 42 patients (18 male, mean age 57.5 ± 11.3) with acute BRVO and a matched control group (by age, sex, and presence of hypertension) with 70 (26 male, mean age 54.4 ± 9.4) patients. All patients and control subjects underwent complete ocular examination and CAVI measurement. BRVO was diagnosed based on clinical examination. Results: There were no significant differences between baseline clinical and demographic characteristics, echocardiographic measurements of left ventricular ejection fraction, systolic and diastolic blood pressure, and body mass index of the BRVO and control group. Both right and left CAVI values were found significantly higher in BRVO group (7.94 ± 1.53 vs 7.28 ± 1.25, P < 0.05 and 8.06 ± 1.41 vs 7.30 ± 1.26, P < 0.05, respectively). There were no significant difference in right and left ankle-brachial index values between the groups (1.05 ± 0.10 vs 1.06 ± 0.08, P = 0.46 and 1.04 ± 0.12 vs 1.05 ± 0.08, P = 0.46, respectively). Conclusion: Arterial stiffness is an important mediator of cardiovascular diseases. We found that CAVI which is a novel marker of the arterial stiffness is increased in patients with acute BRVO compared to controls.
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Affiliation(s)
- Ibrahim Kocayigit
- Sakarya University Education and Research Hospital, Department of Cardiology, Adnan Menderes Caddesi Saglik Sokak, Sakarya, Turkey
| | - Mahmut Atum
- Sakarya University Education and Research Hospital, Department of Cardiology, Adnan Menderes Caddesi Saglik Sokak, Sakarya, Turkey
| | - Salih Sahinkus
- Sakarya University Education and Research Hospital, Department of Cardiology, Adnan Menderes Caddesi Saglik Sokak, Sakarya, Turkey
| | - Murat Aksoy
- Sakarya University Education and Research Hospital, Department of Cardiology, Adnan Menderes Caddesi Saglik Sokak, Sakarya, Turkey
| | - Yusuf Can
- Sakarya University Education and Research Hospital, Department of Cardiology, Adnan Menderes Caddesi Saglik Sokak, Sakarya, Turkey
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15
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Mita T, Someya Y, Osonoi Y, Osonoi T, Saito M, Nakayama S, Ishida H, Sato H, Gosho M, Watada H. Lower intake of saturated fatty acids is associated with persistently higher arterial stiffness in patients with type 2 diabetes. J Diabetes Investig 2021; 12:226-233. [PMID: 32627969 PMCID: PMC7858113 DOI: 10.1111/jdi.13347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022] Open
Abstract
AIMS/INTRODUCTION There are few studies to investigate the relationship between macronutrients and longitudinal changes in arterial stiffness in patients with type 2 diabetes mellitus. This exploratory study sought to determine whether macronutrients were correlated with increased arterial stiffness independently of conventional atherosclerotic risk factors. MATERIALS AND METHODS The study participants comprised 733 type 2 diabetes outpatients who had no apparent history of cardiovascular diseases. The dietary schedule was assessed with a validated, brief, self-administered diet history questionnaire. At baseline and at years 2 and 5, brachial-ankle pulse wave velocity was measured. A multivariable linear mixed-effects model was used to determine the predictive values of macronutrients and atherosclerotic risk factors for longitudinal changes in brachial-ankle pulse wave velocity. RESULTS There was a significant increase in brachial-ankle pulse wave velocity values over the 5-year follow-up period. In a multivariable linear mixed-effects model that adjusted for age and sex, lower saturated fatty acid intake was significantly correlated with persistently higher brachial-ankle pulse wave velocity, independently of other atherosclerotic risk factors. Lower intake of dairy products in particular showed this correlation. CONCLUSIONS Our data showed that lower saturated fatty acids intake was correlated with persistently higher brachial-ankle pulse wave velocity in type 2 diabetes patients. Among food sources of saturated fatty acids, lower dairy products specifically were correlated with elevated brachial-ankle pulse wave velocity. This might be because the consumption of dairy products in Japan is much lower than in Western countries.
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Affiliation(s)
- Tomoya Mita
- Department of Metabolism & EndocrinologyJuntendo University Graduate School of MedicineTokyoJapan
- Center for Molecular DiabetologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Yuki Someya
- Department of Metabolism & EndocrinologyJuntendo University Graduate School of MedicineTokyoJapan
- Sportology CenterJuntendo University Graduate School of MedicineTokyoJapan
| | | | | | | | - Shiho Nakayama
- Department of Metabolism & EndocrinologyJuntendo University Graduate School of MedicineTokyoJapan
| | | | - Hiroaki Sato
- Department of Metabolism & EndocrinologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Masahiko Gosho
- Department of BiostatisticsFaculty of MedicineUniversity of TsukubaIbarakiJapan
| | - Hirotaka Watada
- Department of Metabolism & EndocrinologyJuntendo University Graduate School of MedicineTokyoJapan
- Center for Molecular DiabetologyJuntendo University Graduate School of MedicineTokyoJapan
- Sportology CenterJuntendo University Graduate School of MedicineTokyoJapan
- Center for Therapeutic Innovations in DiabetesJuntendo University Graduate School of MedicineTokyoJapan
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16
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Wakasugi S, Mita T, Katakami N, Okada Y, Yoshii H, Osonoi T, Kuribayashi N, Taneda Y, Kojima Y, Gosho M, Shimomura I, Watada H. Associations between continuous glucose monitoring-derived metrics and arterial stiffness in Japanese patients with type 2 diabetes. Cardiovasc Diabetol 2021; 20:15. [PMID: 33413339 PMCID: PMC7792328 DOI: 10.1186/s12933-020-01194-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Previous studies have suggested that high mean glucose levels and glycemic abnormalities such as glucose fluctuation and hypoglycemia accelerate the progression of atherosclerosis in patients with type 2 diabetes. Although continuous glucose monitoring (CGM) that could evaluate such glycemic abnormalities has been rapidly adopted, the associations between CGM-derived metrics and arterial stiffness are not entirely clear. METHODS This exploratory cross-sectional study used baseline data from an ongoing prospective, multicenter, observational study with 5 years of follow-up. Study participants included 445 outpatients with type 2 diabetes and no history of apparent cardiovascular disease who underwent CGM and brachial-ankle pulse wave velocity (baPWV) measurement at baseline. Associations between CGM-derived metrics and baPWV were analyzed using multivariate regression models. RESULTS In a linear regression model, all CGM-derived metrics were significantly associated with baPWV, but HbA1c was not. Some CGM-derived metrics related to intra-day glucose variability, hyperglycemia, and hypoglycemia remained significantly associated with baPWV after adjusting for possible atherosclerotic risk factors, including HbA1c. Based on baPWV ≥ 1800 cm/s as indicative of high arterial stiffness, multivariate logistic regression found that some CGM-derived metrics related to intra-day glucose variability and hyperglycemia are significantly associated with high arterial stiffness even after adjusting for possible atherosclerotic risk factors, including HbA1c. CONCLUSIONS Multiple CGM-derived metrics are significantly associated with baPWV and high arterial stiffness in patients with type 2 diabetes who have no history of apparent cardiovascular disease. These metrics might be useful for identifying patients at high risk of developing cardiovascular disease.
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Affiliation(s)
- Satomi Wakasugi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1 Bunkyo-ku, Tokyo, Japan
| | - Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1 Bunkyo-ku, Tokyo, Japan.
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.,Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Shinsuna 3-3-20, Koto-ku, Tokyo, 136-0075, Japan
| | - Takeshi Osonoi
- Nakakinen Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan
| | | | | | - Yuichi Kojima
- Musashino Family Clinic, Minami 3-14-1, Yoshikawa, Saitama, 342-0038, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1 Bunkyo-ku, Tokyo, Japan
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17
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Gupta R, Tyagi K, Anoop S, Ghosh A, Misra A. About 1/3rd of north Indian patients less than 50 years of age with type 2 diabetes have high pulse wave velocity indicating high risk of atherosclerosis. Diabetes Metab Syndr 2020; 14:2205-2210. [PMID: 33336647 DOI: 10.1016/j.dsx.2020.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS Asian Indian patients with type 2 diabetes mellitus (T2DM) have a high cardiovascular risk even at young age. There is a need to assess this increased risk and identify atherosclerosis early so that appropriate measures for risk reduction can be taken. We aimed to study carotid-femoral pulse wave velocity (Cf-PWV), a non-invasive indicator of atherosclerosis, in patients with diabetes below 50 years of age and its correlation with markers of obesity and other cardiovascular risk factors. METHODS Patients (n, 299) with T2DM below 50 years of age underwent measurement of Cf-PWV by applanation tonometry. Anthropometric parameters, blood pressure, liver span, glycosylated hemoglobin, serum lipid profile, urinary microalbumin, ankle brachial index and carotid intima media thickness were measured. RESULTS Data show that 32.4% of patients had high Cf-PWV, with mean values higher in males than females. On stepwise multiple linear regression analysis, the significant independent determinants of PWV were age, systolic blood pressure, waist circumference, microalbumin and liver span. CONCLUSION About one third patients with T2DM less than 50 years of age, in north India have increased arterial stiffness which correlates with blood pressure, abdominal obesity, liver size and microalbumin, indicating increased risk for coronary artery disease.
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Affiliation(s)
- Ritesh Gupta
- Fortis CDOC Hospital, Chirag Enclave, New Delhi, India.
| | - Kanika Tyagi
- Fortis CDOC Hospital, Chirag Enclave, New Delhi, India
| | - Shajith Anoop
- National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
| | - Amerta Ghosh
- Fortis CDOC Hospital, Chirag Enclave, New Delhi, India
| | - Anoop Misra
- Fortis CDOC Hospital, Chirag Enclave, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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18
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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. Cardiovasc Diabetol 2020; 19:173. [PMID: 33036608 PMCID: PMC7547471 DOI: 10.1186/s12933-020-01149-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/01/2020] [Indexed: 12/24/2022] Open
Abstract
Background Peripheral artery disease (PAD) in the lower extremities is a common complication of type 2 diabetes and has been shown to be associated with mortality. The ankle-brachial index (ABI) is a simple noninvasive method to screen PAD, but this method has limited sensitivity. We hypothesized that using the percentage of mean arterial pressure (%MAP) in combination with the ABI would improve the prediction of mortality. Methods We retrospectively collected data from patients with type 2 diabetes who had undergone ABI and %MAP measurements at our hospital. We separated the cohort into four groups according to their ABI and %MAP values, and we examined whether these indices were associated with mortality. Results A total of 5569 patients (mean age, 65 ± 11 years) were enrolled. During the follow-up period (median, 22.9 months), 266 (4.8%) of the enrolled patients died. The combination of ABI and %MAP was significantly more effective than ABI alone for predicting mortality (C index of 0.62, 95% confidence interval [CI] of 0.57 to 0.65 vs. C index of 0.57, 95% CI of 0.53 to 0.62; P = 0.038). In multivariate analysis (with a reference group defined by ABI > 0.90 and %MAP ≤ 45%), the highest risk of mortality was seen in patients with ABI ≤ 0.90 and %MAP > 45% (hazard ratio = 2.045 [95% CI 1.420, 2.945], P < 0.001). Conclusions The use of %MAP alongside ABI appears to significantly improve the prediction of all-cause mortality in patients with type 2 diabetes.
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Lim TH, Chung SM, Lee DS, Choi SR, Moon JS, Yoon JS, Won KC, Lee HW. Peripheral Arterial Stiffness Increases the Risk of Progression of Renal Disease in Type 2 Diabetic Patients. Front Med (Lausanne) 2020; 7:588967. [PMID: 33102509 PMCID: PMC7554614 DOI: 10.3389/fmed.2020.588967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/24/2020] [Indexed: 11/23/2022] Open
Abstract
Aims: Our aim was to investigate the effects of peripheral arterial stiffness on the risk of progression of renal disease in patients with type 2 diabetes (T2D). Methods: This was a single center, retrospective cohort study. Brachial-ankle pulse wave velocity (baPWV) tests were performed on T2D patients in 2015. Increased arterial stiffness was defined as baPWV of ≥ 1800 cm/s. We applied criteria for progression of renal disease according to EMPA-REG OUTCOME trial. Results: In total, 186 patients were enrolled in the final study. The mean age was 59.1 years and male:female ratio was 1.73:1. Thirteen (7%) patients progressed to renal disease during the average follow-up time of 35.3 months. In particular, the risk of progression to macroalbuminuria was significantly higher in the baPWV ≥ 1800 cm/s group (HR 6.216, p = 0.020). Individuals with a baPWV of ≥ 1800 cm/s (when comparisons were adjusted for age, sex, blood pressure, diabetes duration, eGFR, and use of renin-angiotensin system inhibitors) had a significantly higher risk of the progression of renal disease (HR = 8.480, p = 0.014). Conclusion: These results suggest that peripheral arterial stiffness (baPWV ≥ 1800 cm/s) may be a risk factor for the progression of renal disease in T2D patients.
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Affiliation(s)
- Tae Hoon Lim
- College of Medicine, Yeungnam University, Daegu, South Korea
| | - Seung Min Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
| | - Dong Sung Lee
- College of Medicine, Yeungnam University, Daegu, South Korea
| | - Se Ra Choi
- College of Medicine, Yeungnam University, Daegu, South Korea
| | - Jun Sung Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
- *Correspondence: Jun Sung Moon
| | - Ji Sung Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
| | - Kyu Chang Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
| | - Hyoung Woo Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
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Barroso WKS, Melo MDA, Vitorino PV, Gonçalves C, Berigó JA, Arantes AC, Rezende J, Jardim TV, Souza ALL, Jardim PCV. Carotid Intima and Media Thickness Correlation with Central Blood Pressure Measurements by Tonometric and Oscillometric Methods: A Proof of Concept. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2020. [DOI: 10.36660/ijcs.20190117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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21
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Gouliopoulos N, Siasos G, Moschos MM, Oikonomou E, Rouvas A, Bletsa E, Stampouloglou P, Siasou G, Paraskevopoulos T, Vlasis K, Marinos G, Tousoulis D. Endothelial dysfunction and impaired arterial wall properties in patients with retinal vein occlusion. Vasc Med 2020; 25:302-308. [PMID: 32308146 DOI: 10.1177/1358863x20913609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Retinal vein occlusion (RVO) is a common retinal vascular lesion, and a leading cause of visual impairment. Patients with RVO have an increased risk for cardiovascular disease and share multiple common risk factors. In this study, we investigated the endothelial function and arterial stiffness of patients with RVO compared to healthy-control (CL) subjects. We enrolled 40 consecutive patients with RVO and 40 CL subjects. RVO was diagnosed by an ophthalmologist, endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery, and carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) of the radial artery were measured to evaluate arterial stiffness and reflected waves, respectively. No significant differences were detected between the studied groups in sex, age, presence of hypertension or dyslipidemia, body mass index, systolic and diastolic blood pressure levels, total cholesterol levels, and smoking habits (p > 0.05 for all). However, patients with RVO had impaired FMD (p = 0.002) and increased PWV (p = 0.004), even after adjustment for several confounders. Both FMD and PWV were also significantly and independently associated with the development of RVO. Furthermore, a significant and positive correlation between PWV and systolic blood pressure existed only in the CL group. Therefore, we have shown that RVO is associated with significant endothelial dysfunction and increased arterial stiffness. Our results strengthen the vascular theory, according to which, systemic endothelial dysfunction and arteriosclerosis play a significant role in the pathogenesis of RVO.
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Affiliation(s)
- Nikolaos Gouliopoulos
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration Hospital, Athens, Greece
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marilita M Moschos
- 1st Department of Ophthalmology, Gennimatas General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Evangelos Oikonomou
- 1st Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Alexandros Rouvas
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evanthia Bletsa
- 1st Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Panagiota Stampouloglou
- 1st Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Georgia Siasou
- 1st Department of Ophthalmology, Gennimatas General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Konstantinos Vlasis
- Department of Anatomy, Laiko General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Georgios Marinos
- Department of Anatomy, Laiko General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Tousoulis
- 1st Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration Hospital, Athens, Greece
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22
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Orlandi M, Graziani F, D'Aiuto F. Periodontal therapy and cardiovascular risk. Periodontol 2000 2020; 83:107-124. [PMID: 32385887 DOI: 10.1111/prd.12299] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases are the worldwide leading cause of mortality. Cardiovascular diseases are noncommunicable conditions with a complex pathogenesis, and their clinical manifestations include major cardiovascular events such as myocardial infarction and stroke. Epidemiologic evidence suggests a consistent association between periodontitis and increased risk of cardiovascular diseases. Some evidence supports a beneficial effect of the treatment of periodontitis on both surrogate and hard cardiovascular outcomes. This narrative review has been conducted as an update of the most recent evidence on the effects of periodontitis treatment on cardiovascular outcomes since the last commissioned review of the European Federation of Periodontology-American Academy of Periodontology World Workshop in 2012. Newer evidence originating from published randomized controlled trials confirms a positive effect of periodontal treatment on surrogate measures of cardiovascular diseases, whereas there have been no randomized controlled trials investigating the effect of periodontal treatment on the incidence of cardiovascular disease events such as myocardial infarction and stroke. In conclusion, there is sufficient evidence from observational and experimental studies on surrogate cardiovascular measures to justify the design and conduct of appropriately powered randomized controlled trials investigating the effect of effective periodontal interventions on cardiovascular disease outcomes (ie, myocardial infarction and stroke) with adequate control of traditional cardiovascular risk factors.
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Affiliation(s)
- Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
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23
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Liao CK, Tsai JS, Lin LY, Lee SC, Lai CF, Ho TW, Lai F. Characteristics of Harmonic Indexes of the Arterial Blood Pressure Waveform in Type 2 Diabetes Mellitus. Front Bioeng Biotechnol 2020; 8:638. [PMID: 32733859 PMCID: PMC7360801 DOI: 10.3389/fbioe.2020.00638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/26/2020] [Indexed: 01/14/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is an important public health issue worldwide. T2DM correlates with cardiovascular disease. Arterial stiffness is also a key factor that can be thought of as a surrogate marker. Nevertheless, it was unclear which harmonic indexes of blood pressure waveforms (BPWs) from subjects' radial artery pulses would be affected by T2DM. Therefore, the objective of this study was to investigate whether and how harmonic indexes can be used to discriminate hemodynamic differences between patients with T2DM and non-T2DM. This helps us to build objective results no matter who conducts the examination instead of pulse diagnosis in traditional way. We enrolled T2DM and non-T2DM patients as experimental and control groups, respectively, from the Department of Family Medicine in the National Taiwan University Hospital and the Department of Internal Medicine in Taipei's Veterans General Hospital from December 2017 to January 2019. ANSWatch® Model TS-0411 was used to capture the BPWs. Amplitude proportions (Cn values) were calculated from harmonics 1-10 of the BPW using fast Fourier transform. Thirty-two T2DM and 15 non-T2DM patients were enrolled. T2DM patients had significant differences in C1 (p = 0.031) and C5 (p = 0.041). The study suggests that analyzing the harmonic characteristics of non-invasively measured BPW of radial artery may be a potential and easy-to-perform approach to discriminate T2DM-induced hemodynamic changes.
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Affiliation(s)
- Chen-Kai Liao
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.,Lao De Yan Traditional Chinese Medicine Clinic, New Taipei City, Taiwan
| | - Jaw-Shiun Tsai
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Yu Lin
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Si-Chen Lee
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.,Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Chun-Fu Lai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Te-Wei Ho
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Feipei Lai
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.,Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan.,Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
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24
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Liu SC, Chuang SM, Shih HM, Wang CH, Tsai MC, Lee CC. High pulse wave velocity is associated with the severity of diabetic retinopathy in patients with type 2 diabetes. J Investig Med 2020; 68:1159-1165. [PMID: 32595133 DOI: 10.1136/jim-2019-001240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 11/03/2022]
Abstract
Pulse wave velocity (PWV) is a non-invasive test for assessing arterial stiffness, and brachial-ankle PWV has been used as an index of peripheral arterial stiffness. This study aimed to investigate the association between the PWV value and severity of diabetic retinopathy (DR). 846 patients with type 2 diabetes (T2DM) consecutively underwent brachial-ankle PWV, and the degree of PWV was defined by tertile. The severity of DR was categorized as no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) based on the Early Treatment Diabetic Retinopathy Study Scale. Multinomial logistic regression analyses were utilized not only to explore the association between the degree of PWV and severity of DR but also to examine the association of a high-tertile PWV with PDR. PWV levels, diabetes duration and blood pressure were all significantly higher in subjects with NPDR or PDR as compared with individuals with NDR. In the univariate analysis, the highest tertile of PWV (>19.6 m/s) was significantly associated with both NPDR (p<0.001) and PDR (p<0.001) as compared with NDR. After adjusting for confounding factors, the highest tertile of PWV remained significantly associated with PDR (p=0.005), but not with NPDR (p=0.107). Furthermore, the highest tertile of PWV was more significantly associated with PDR (OR=6.15, 95%CI 1.38 to 27.38) as compared with the lowest tertile. In our study, an increasing degree of PWV was positively associated with the severity of DR. High PWV was strongly associated with the risk of severe DR, especially PDR.
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Affiliation(s)
- Sung-Chen Liu
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, Sanzhi, Taipei, Taiwan
| | - Shih-Ming Chuang
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medical, Nursing, and Management, Taipei, Taiwan
| | - Hong-Mou Shih
- Division of Nephrology, Mackay Memorial Hospital, Taipei, Taiwan
- Graduate Institute of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chao-Hung Wang
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ming-Chieh Tsai
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chun-Chuan Lee
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
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25
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Shirokane K, Tamaki T, Kim K, Tsuchiya M, Yamazaki M, Morita A. Relationship between Flow-mediated Endothelial Vasodilation and the Pulse Wave Velocity, and Cervical Carotid Artery Stenosis. Neurol Med Chir (Tokyo) 2020; 60:293-298. [PMID: 32404574 PMCID: PMC7301127 DOI: 10.2176/nmc.oa.2019-0193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Carotid artery stenosis is elicited by atherosclerosis and is the main cause of cerebral thrombosis. Flow-mediated endothelial vasodilation (FMD) can be measured noninvasively to assess vascular endothelial function related to atherosclerosis. The pulse wave velocity (PWV) is used to evaluate the vascular media involved in atherosclerosis. We investigated the relationship between these measurements in 75 consecutive patients with atherosclerotic cerebral thrombosis. They were assigned to three equal groups based on the severity of carotid artery stenosis on ultrasonograms. Group 1 had no stenosis, group 2 manifested moderate stenosis (<60%), and group 3 presented with severe stenosis (≥60%). We compared the FMD and PWV among the three groups. The PWV was significantly lower in group 1 than the other two groups. The FMD was significantly lower in group 3; it was significantly lower in group 2 than group 1. There was an inverse correlation between the FMD and the severity of carotid artery stenosis. Our findings show that for assessing the severity of carotid artery stenosis, the FMD is more useful than the PWV.
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Affiliation(s)
- Kazutaka Shirokane
- Department of Neurological Surgery, Tama Nagayama Hospital, Nippon Medical School.,Department of Neurological Surgery, Chiba Hokusoh Hospital, Nippon Medical School
| | - Tomonori Tamaki
- Department of Neurological Surgery, Tama Nagayama Hospital, Nippon Medical School
| | - Kyongsong Kim
- Department of Neurological Surgery, Chiba Hokusoh Hospital, Nippon Medical School
| | | | - Michio Yamazaki
- Department of Neurological Surgery, Tama Nagayama Hospital, Nippon Medical School
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26
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Pan J, Liu J, Wang H, Li W, Du X, Lin Q, Zhang X, Qi D, Tu J, Ning X, Yang Q, Wang J. Association of Carotid Atherosclerosis With Lipid Components in Asymptomatic Low-Income Chinese: A Population-Based Cross-Sectional Study. Front Neurol 2020; 11:276. [PMID: 32390928 PMCID: PMC7193094 DOI: 10.3389/fneur.2020.00276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/25/2020] [Indexed: 12/25/2022] Open
Abstract
Intima-media thickness is a non-invasive arterial marker of early-stage atherosclerosis. Identifying carotid plaque is a superior surrogate endpoint for assessing atherosclerotic lesions. The aim of this study was to investigate the association of carotid intima-media thickness (CIMT) and carotid plaque with lipids among asymptomatic low-income rural residents in China. A total of 3,789 people aged ≥45 years without a history of stroke or cardiovascular disease were recruited to this study. B-mode ultrasonography was performed to measure CIMT and identify carotid plaque for early identification of atherosclerosis. Multivariate analysis was used to assess the association of blood lipid levels with atherosclerosis. The mean CIMT across our cohort was 567 μm. A linear regression analysis showed that low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) were risk factors for early-stage atherosclerosis; however, high-density lipoprotein cholesterol and triglycerides protected against early-stage atherosclerosis after adjusting for potential risk factors (P < 0.001). Carotid plaque risk increased by 24 and 62% for each 1-mmol/L increase in TC and LDL-C (P < 0.001). These findings suggest that it is vital to manage and control the dyslipidemia standard levels in China, especially among rural residents, in order to reduce the burden of cardiovascular diseases.
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Affiliation(s)
- Jing Pan
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin, China
| | - Hong Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Weilan Li
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Du
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin, China
| | - Xinxin Zhang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Dongwang Qi
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin, China
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Patoulias D, Papadopoulos C, Stavropoulos K, Zografou I, Doumas M, Karagiannis A. Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium-glucose co-transporter-2 inhibitors. J Clin Hypertens (Greenwich) 2020; 22:562-571. [PMID: 32058679 PMCID: PMC8029715 DOI: 10.1111/jch.13831] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/02/2019] [Accepted: 12/10/2019] [Indexed: 12/12/2022]
Abstract
Type 2 diabetes mellitus (T2DM) constitutes a global pandemic, representing the 7th cause of death worldwide. Morbidity and mortality of patients with T2DM are gradually increasing, while prevalence of cardiovascular disease (CVD) among these patients is almost 14% greater compared to the general population. Arterial stiffness is nowadays a valuable biomarker of CVD and a promising treatment target in specific patient groups, including those suffering from T2DM. Despite that fact, design of the available studies cannot prove causal relationship. Recently, a new antidiabetic drug class, namely sodium-glucose co-transporter-2 (SGLT-2) inhibitors, has attracted scientific interest, due to their multiple, beneficial, pleiotropic effects, especially those focused on CVD. There is limited relevant literature concerning the effects of SGLT-2 inhibitors on arterial stiffness, while retrieved results might be considered as conflicting. The aim of the present review article is to summarize acquired knowledge regarding the prognostic role of arterial stiffness in T2DM, along with the presentation of retrieved data on the potential role of SGLT-2 inhibitors.
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Affiliation(s)
- Dimitrios Patoulias
- Second Propedeutic Department of Internal MedicineGeneral Hospital “Hippokration”Aristotle University of ThessalonikiThessalonikiGreece
| | - Christodoulos Papadopoulos
- Third Department of CardiologyGeneral Hospital “Hippokration”Aristotle University of ThessalonikiThessalonikiGreece
| | - Konstantinos Stavropoulos
- Second Propedeutic Department of Internal MedicineGeneral Hospital “Hippokration”Aristotle University of ThessalonikiThessalonikiGreece
| | - Ioanna Zografou
- Second Propedeutic Department of Internal MedicineGeneral Hospital “Hippokration”Aristotle University of ThessalonikiThessalonikiGreece
| | - Michael Doumas
- Second Propedeutic Department of Internal MedicineGeneral Hospital “Hippokration”Aristotle University of ThessalonikiThessalonikiGreece
- Veterans Affair Medical CenterGeorge Washington UniversityWashingtonDCUSA
| | - Asterios Karagiannis
- Second Propedeutic Department of Internal MedicineGeneral Hospital “Hippokration”Aristotle University of ThessalonikiThessalonikiGreece
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28
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Mita T, Osonoi Y, Osonoi T, Saito M, Nakayama S, Someya Y, Ishida H, Gosho M, Watada H. Breakfast skipping is associated with persistently increased arterial stiffness in patients with type 2 diabetes. BMJ Open Diabetes Res Care 2020; 8:8/1/e001162. [PMID: 32098899 PMCID: PMC7206922 DOI: 10.1136/bmjdrc-2019-001162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/11/2020] [Accepted: 01/28/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE While certain lifestyle habits may be associated with arterial stiffness, there is limited literature investigating the relationship between lifestyle habits and longitudinal changes in arterial stiffness in patients with type 2 diabetes mellitus (T2DM). This is an exploratory study to determine whether lifestyle habits, in addition to conventional atherosclerotic risk factors, are associated with increased arterial stiffness. RESEARCH DESIGN AND METHODS The study participants comprised 734 Japanese outpatients with T2DM and no history of apparent cardiovascular diseases. Lifestyle habits were analyzed using self-reported questionnaires, and brachial-ankle pulse wave velocity (baPWV) was measured at baseline, and at years 2 and 5. A multivariable linear mixed-effects model was used to determine the predictive value of lifestyle habits and possible atherosclerotic risk factors for longitudinal change in baPWV. RESULTS Over 5 years of follow-up, baPWV values significantly increased. In a multivariable linear mixed-effects model that adjusted for age and gender, a low frequency of breakfast intake was significantly associated with persistently high baPWV, independently of other lifestyle habits. Furthermore, in a multivariable linear mixed-effects model that included both lifestyle habits and possible atherosclerotic risk factors, a low frequency of breakfast intake remained the only independent predictive factor for persistently high baPWV. Subjects who ate breakfast less frequently tended to have additional unhealthy lifestyle habits and atherosclerotic risk factors. CONCLUSIONS Our analyses suggest that breakfast skipping is an independent lifestyle habit that is associated with persistently increased arterial stiffness in patients with T2DM. TRIAL REGISTRATION NUMBER UMIN000010932.
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Affiliation(s)
- Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
- Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yusuke Osonoi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
| | | | | | - Shiho Nakayama
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
| | - Yuki Someya
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
| | | | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
- Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Giraldo-Grueso M, Echeverri D. From Endothelial Dysfunction to Arterial Stiffness in Diabetes Mellitus. Curr Diabetes Rev 2020; 16:230-237. [PMID: 30332971 DOI: 10.2174/1573399814666181017120415] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/02/2018] [Accepted: 10/11/2018] [Indexed: 11/22/2022]
Abstract
Prevalence of diabetes mellitus has increased drastically over time, especially in more populous countries such as the United States, India, and China. Patients with diabetes have an increased risk of major cardiovascular events such as acute myocardial infarction, cerebrovascular disease, and peripheral vascular disease. Arterial stiffness is a process related to aging and vascular, metabolic, cellular and physiological deterioration. In recent years, it has been described as an independent predictor of cardiovascular mortality and coronary artery disease. Additionally, it plays an important role in the measurement of chronic disease progression. Recent studies have suggested a strong relationship between diabetes mellitus and arterial stiffness since they share a similar pathophysiology involving endothelial dysfunction. The literature has shown that microvascular and macrovascular complications in diabetic patients could be screened and measured with arterial stiffness. Additionally, new evidence proposes that there is a relationship between blood glucose levels, microalbuminuria, and arterial stiffness. Moreover, arterial stiffness predicts cardiovascular risk and is independently associated with mortality in diabetic patients. Abnormal arterial stiffness values in diabetic patients should alert the clinician to the presence of vascular disease, which merits early study and treatment. We await more studies to determine if arterial stiffness could be considered a routine useful non-invasive tool in the evaluation of diabetic patients. There is enough evidence to conclude that arterial stiffness is related to the progression of diabetes mellitus.
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Affiliation(s)
- Manuel Giraldo-Grueso
- Vascular Function Research Laboratory, Fundación Cardioinfantil-Instituto de Cardiologia, Universidad del Rosario, Medical School, Bogota, Colombia
| | - Darío Echeverri
- Vascular Function Research Laboratory, Fundación Cardioinfantil-Instituto de Cardiologia, Universidad del Rosario, Medical School, Bogota, Colombia
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Shalash MAM, Rohoma KH, Kandil NS, Abdel Mohsen MA, Taha AAF. Serum sclerostin level and its relation to subclinical atherosclerosis in subjects with type 2 diabetes. J Diabetes Complications 2019; 33:592-597. [PMID: 31129005 DOI: 10.1016/j.jdiacomp.2019.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 03/18/2019] [Accepted: 04/21/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Sclerostin, a Wnt-signalling inhibitor, is an established negative regulator of bone formation. However, data regarding its potential importance in vascular disease are less clear. Common carotid artery media thickness (CIMT) assessment and plaque identification using ultrasound imaging are well-recognized tools for identifying and monitoring atherosclerosis. The aim of the present study is to examine the relationship between serum sclerostin and subclinical atherosclerosis (as evidenced by CIMT). METHODS This cross-sectional study included 50 subjects with T2DM and 20 subjects as a control group. Multivariable linear regression models were used to assess the association of sclerostin with subclinical atherosclerosis. RESULTS Serum sclerostin levels in T2DM patients were significantly higher compared to the control group (167.16 ± 63.60 versus 85.98 ± 23.74 pg/ml, P < 0.0001). A concentration of ≥162.5 pg/ml showed a sensitivity of 90% and a specificity of 86.67% to detect an increased risk of subclinical atherosclerosis. Univariate analysis revealed a significant positive correlation between serum sclerostin and CIMT (r = 0.635, P < 0.001). Sclerostin concentrations remained independently associated with CIMT (β = 63.188 [6.919-119.456], P = 0.017) after adjusting for age and gender. CONCLUSION Our data suggest a positive correlation between serum sclerostin level and subclinical atherosclerosis in subjects with type 2 diabetes mellitus.
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Affiliation(s)
- Magui Abdel Moneim Shalash
- Department of Internal Medicine (Unit of Diabetes and Metabolism), Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Kamel Hemida Rohoma
- Department of Internal Medicine (Unit of Diabetes and Metabolism), Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Noha Said Kandil
- Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | | | - Aya Abdul Fattah Taha
- Department of Internal Medicine (Unit of Diabetes and Metabolism), Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Omboni S, Posokhov I, Parati G, Rogoza A, Kotovskaya Y, Arystan A, Avolio A, Barkan V, Bulanova N, Cardona Muñoz E, Grigoricheva E, Konradi A, Minyukhina I, Muiesan ML, Mulè G, Orlova I, Pereira T, Peixoto Maldonado JM, Statsenko ME, Tilea I, Waisman G, Rogoza A, Forcada P, Zelveian P, Butlin M, Barin E, Tan I, Ghiadoni L, Bruno RM, Sarzani R, Espinosa E, Volpe M, Savoia C, Tocci G, Borghi C, Schillaci G, Pucci G, Paini A, Rizzoni D, Ramos C, Alanis A, Varga A, Volkov D, Kurlykina N, Rotar O, Orlov A, Gorbunov V, Boytsov S, Fedorova E, Korneva V, Kuznetsova T, Kulikova N, Evdokimov VV, Kuznetsova A, Zheleznyak E, Kobalava Z, Borisova I, Svetozarsky T, Gubanova M, Lazareva V, Derevyanchenko MV, Kopylov P, Sirenko Y, Recovets O. Ambulatory blood pressure and arterial stiffness web‐based telemonitoring in patients at cardiovascular risk. First results of the VASOTENS (Vascular health ASsessment Of The hypertENSive patients) Registry. J Clin Hypertens (Greenwich) 2019; 21:1155-1168. [DOI: 10.1111/jch.13623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Stefano Omboni
- Clinical Research Unit Italian Institute of Telemedicine Varese Italy
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | - Igor Posokhov
- Hemodynamic Laboratory Ltd Nizhniy Novgorod Russian Federation
| | - Gianfranco Parati
- Department of Cardiology Istituto Auxologico Italiano Milan Italy
- Department of Medicine and Surgery University of Milano‐Bicocca Milan Italy
| | - Anatoly Rogoza
- Department of New Diagnostic Methods Russian Cardiology Research and Production Complex Moscow Russian Federation
| | - Yulia Kotovskaya
- Russian Clinical and Research Center of Gerontology Pirogov Russian National Research Medical Moscow Russian Federation
| | - Ayana Arystan
- Department of Functional Diagnostics Medical Center Hospital of President’s Affairs Administration of The Republic of Kazakhstan Astana Kazakhstan
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia
| | - Vitaliy Barkan
- Diagnostics Department The Hospital within the Russian Railroad Network Chita Russian Federation
| | - Natalia Bulanova
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | | | | | - Alexandra Konradi
- Department of Epidemiology North‐West Federal Medical Research Center St. Petersburg Russian Federation
| | - Irina Minyukhina
- Lomonosov Moscow State University Clinic Moscow Russian Federation
| | - Maria Lorenza Muiesan
- Dipartimento di Scienze Mediche e Chirurgiche Università di Brescia, Medicina 2 Brescia Italy
| | - Giuseppe Mulè
- Unità Operativa di Nefrologia ed Ipertensione, Centro di Riferimento Regionale per l'Ipertensione Arteriosa Policlinico Paolo Giaccone Palermo Italy
| | - Iana Orlova
- Volga District Medical Center Nizhniy Novgorod Russian Federation
| | - Telmo Pereira
- Escola Superior de Tecnologia da Saúde de Coimbra Instituto Politécnico de Coimbra Coimbra Portugal
| | | | | | - Ioan Tilea
- Cardiac Rehabilitation Clinic Tirgu Mures Emergency Clinical County Hospital Tirgu Mures Romania
| | - Gabriel Waisman
- Servicio de Clínica Médica y Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Buenos Aires Argentina
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Zi H, Wang XJ, Zhao MJ, Huang Q, Wang XH, Zeng XT. Fasting blood glucose level and hypertension risk in aging benign prostatic hyperplasia patients. Aging (Albany NY) 2019; 11:4438-4445. [PMID: 31280253 PMCID: PMC6660045 DOI: 10.18632/aging.102061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
Abstract
Evidence suggests there maybe an association among abnormal fasting blood glucose, hypertension and benign prostatic hyperplasia. In this study, we investigated whether abnormal fasting blood glucose correlates with hypertension in aging benign prostatic hyperplasia patients. Ultimately, 612 benign prostatic hyperplasia patients, including 230 hypertensive patients and 382 normotensive patients, were included. Univariate and multivariate logistic regression analyses were used to evaluate the associations. The results indicated that neither impaired fasting glucose/high risk of type 2 diabetes mellitus nor high risk of type 2 diabetes mellitus were associated with an increased risk of hypertension. When patients were stratified based on the severity of their hypertension, similar results were obtained (all P> 0.05). After adjusting for confounding factors, the nonsignificant tendencies for high risk of type 2 diabetes mellitus and impaired fasting glucose/high risk of type 2 diabetes mellitus to associate with hypertension persisted (all P> 0.05). Unlike earlier studies, the present study suggests that the level of fasting blood glucose may not be significantly related to hypertension in aging patients with benign prostatic hyperplasia.
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Affiliation(s)
- Hao Zi
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
- Center for Evidence-Based Medicine, Institute of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, Henan 475000, China
| | - Xue-Jun Wang
- Department of Emergency, Beijing Electric Power Hospital, Beijing 100073, China
| | - Ming-Juan Zhao
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
- Center for Evidence-Based Medicine, Institute of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, Henan 475000, China
- Department of Cardiology, The First Affiliated Hospital of Henan University, Kaifeng, Henan 475000, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Xing-Huan Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Xian-Tao Zeng
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
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Kim HL, Kim SH. Pulse Wave Velocity in Atherosclerosis. Front Cardiovasc Med 2019; 6:41. [PMID: 31024934 DOI: 10.3389/fcvm.2019.00041/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/21/2019] [Indexed: 05/25/2023] Open
Abstract
Early detection of subclinical atherosclerosis is important to reduce patients' cardiovascular risk. However, current diagnostic strategy focusing on traditional risk factors or using risk scoring is not satisfactory. Non-invasive imaging tools also have limitations such as cost, time, radiation hazard, renal toxicity, and requirement for specialized techniques or instruments. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress by arterial stiffening causes endothelial dysfunction, accelerates the formation of atheroma, and stimulates excessive collagen production and deposition in the arterial wall, leading to the progression of atherosclerosis. Pulse wave velocity (PWV), the most widely used measure of arterial stiffness, has emerged as a useful tool for the diagnosis and risk stratification of cardiovascular disease (CVD). The measurement of PWV is simple, non-invasive, and reproducible. There have been many clinical studies and meta-analyses showing the association between PWV and coronary/cerebral/carotid atherosclerosis. More importantly, longitudinal studies have shown that PWV is a significant risk factor for future CVD independent of well-known cardiovascular risk factors. The measurement of PWV may be a useful tool to select subjects at high risk of developing subclinical atherosclerosis or CVD especially in mass screening.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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Kim HL, Kim SH. Pulse Wave Velocity in Atherosclerosis. Front Cardiovasc Med 2019; 6:41. [PMID: 31024934 PMCID: PMC6465321 DOI: 10.3389/fcvm.2019.00041] [Citation(s) in RCA: 256] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/21/2019] [Indexed: 12/18/2022] Open
Abstract
Early detection of subclinical atherosclerosis is important to reduce patients' cardiovascular risk. However, current diagnostic strategy focusing on traditional risk factors or using risk scoring is not satisfactory. Non-invasive imaging tools also have limitations such as cost, time, radiation hazard, renal toxicity, and requirement for specialized techniques or instruments. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress by arterial stiffening causes endothelial dysfunction, accelerates the formation of atheroma, and stimulates excessive collagen production and deposition in the arterial wall, leading to the progression of atherosclerosis. Pulse wave velocity (PWV), the most widely used measure of arterial stiffness, has emerged as a useful tool for the diagnosis and risk stratification of cardiovascular disease (CVD). The measurement of PWV is simple, non-invasive, and reproducible. There have been many clinical studies and meta-analyses showing the association between PWV and coronary/cerebral/carotid atherosclerosis. More importantly, longitudinal studies have shown that PWV is a significant risk factor for future CVD independent of well-known cardiovascular risk factors. The measurement of PWV may be a useful tool to select subjects at high risk of developing subclinical atherosclerosis or CVD especially in mass screening.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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Engelbrechtsen L, Appel VE, Schnurr TM, Lundby-Christensen L, Skaaby T, Linneberg A, Drivsholm T, Witte DR, Jorgensen ME, Grarup N, Pedersen O, Hansen T, Vestergaard H. Genetic determinants of blood pressure traits are associated with carotid arterial thickening and plaque formation in patients with type 2 diabetes. Diab Vasc Dis Res 2019; 16:13-21. [PMID: 30789093 DOI: 10.1177/1479164118810365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of this study is to explore the contribution of genetically driven cardiometabolic risk factors for development of carotid arterial thickening in patients with type 2 diabetes. METHODS In total, 12 genetic risk scores for blood pressure, blood lipids and glycaemic traits were constructed. The genetic risk scores were tested for association with carotid intima-media thickness and plaques in patients with type 2 diabetes ( n = 401) and in non-diabetic individuals ( n = 648) and for association with glucose levels in two population-based cohorts ( n = 1328 and n = 6161). RESULTS In patients with type 2 diabetes, the genetic risk scores for pulse pressure were positively associated with plaque formation ( β = 0.036 ± 0.01 standard deviation/allele, p = 0.003). The genetic risk score for diastolic blood pressure was negatively associated with carotid intima-media thickness ( β = -0.037 ± 0.01 standard deviation/allele, p = 0.005), although not significant after correction for multiple testing ( p < 0.0042). In a meta-analysis of individuals with and without type 2 diabetes, the high-density lipoprotein genetic risk scores showed a trend towards an inverse association with carotid intima-media thickness and plaques, while the low-density lipoprotein genetic risk scores showed a trend towards a positive association with plaque formation but did reach the statistical threshold. CONCLUSION Genetic loci for pulse pressure are associated with plaque formation among patients with type 2 diabetes, suggesting an underlying genetic contribution to arterial stiffening and atherosclerosis.
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Affiliation(s)
- Line Engelbrechtsen
- 1 Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- 2 Danish Diabetes Academy, Odense, Denmark
| | - Vincent E Appel
- 1 Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Theresia M Schnurr
- 1 Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Thea Skaaby
- 4 Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
| | - Allan Linneberg
- 4 Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
- 5 Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Drivsholm
- 4 Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
- 6 The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Daniel R Witte
- 2 Danish Diabetes Academy, Odense, Denmark
- 7 Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Marit E Jorgensen
- 8 Steno Diabetes Center Copenhagen, Gentofte, Denmark
- 9 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Niels Grarup
- 1 Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- 1 Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- 1 Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Vestergaard
- 1 Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- 7 Department of Public Health, Aarhus University, Aarhus, Denmark
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Pan FS, Xu M, Yu L, Luo J, Li MY, Liang JY, Zheng YL, Xie XY. Relationship between carotid intima-media thickness and carotid artery stiffness assessed by ultrafast ultrasound imaging in patients with type 2 diabetes. Eur J Radiol 2018; 111:34-40. [PMID: 30691662 DOI: 10.1016/j.ejrad.2018.12.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/03/2018] [Accepted: 12/13/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To evaluate the relationship between carotid stiffness and carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM). MATERIALS AND METHODS Carotid properties were evaluated in 317 consecutive subjects (98 volunteers for controls, 105 patients with normal CIMT for T2DM group 1, and 114 patients with thickened CIMT for T2DM group 2). The CIMT and carotid pulse wave velocity at the beginning (PWV-BS) and at the end of systole (PWV-ES) were measured. RESULTS Apart from PWV-BS in T2DM group 1, CIMT and PWV-ES were significant higher in patients groups than those of in controls. In multiple regression analysis, diabetes was independently associated with PWV-ES and not with PWV-BS. Moreover, when adjusting for baseline covariates, only PWV-ES (odds ratio = 4.27, P < 0.001) distinguished carotid in T2DM group 1 from that of controls. Concerning the relationship between log(CIMT) and PWV-ES, when adjusting for baseline covariates, the association were still significant in controls and T2DM group 1, whereas it was no longer present in T2DM group 2 (P = 0.091). Additionally, the slope (β) after adjustment for the PWV-ES to log(CIMT) was significantly steeper in T2DM group 1 than that of in controls (β= 8.35 vs. 3.31, P < 0.01). CONCLUSIONS The PWV-ES seem to be a better biomarker candidate than PWV-BS to assess the carotid stiffness in diabetic patients. Compared with controls, diabetic patients showed more advanced functional changes than morphological changes despite normal CIMT, whereas the relationship trend was not present when thickened CIMT emerged.
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Affiliation(s)
- Fu-Shun Pan
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Ming Xu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Liang Yu
- Department of Vascular and Thyroid Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Jia Luo
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Man-Ying Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Jin-Yu Liang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Yan-Ling Zheng
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Xiao-Yan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
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Pan FS, Yu L, Luo J, Wu RD, Xu M, Liang JY, Zheng YL, Xie XY. Carotid Artery Stiffness Assessment by Ultrafast Ultrasound Imaging: Feasibility and Potential Influencing Factors. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2759-2767. [PMID: 29672890 DOI: 10.1002/jum.14630] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/31/2018] [Accepted: 02/20/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To evaluate the feasibility of the ultrafast ultrasound pulsed wave velocity (PWV) for carotid stiffness assessment and potential influencing factors. METHODS Ultrafast PWV measurements of 442 carotid arteries in 162 consecutive patients (patient group) and 66 healthy volunteers (control group) were performed. High- and very high-frequency transducers were used in 110 carotid segments. The ultrafast PWVs at the beginning and end of systole were automatically measured. The correlations between the intima-media thickness (IMT) and ultrafast PWV and the equipment and carotid factors influencing the utility of ultrafast PWV were analyzed. RESULTS Each ultrafast PWV acquisition was completed within 1 minute. The intraobserver variability showed mean differences ± SD of 0.12 ± 1.28 m/s for the PWV before systole and 0.06 ± 1.30 m/s for the PWV at the end of systole. Ultrafast PWV measurements were more likely obtained with the very high- frequency transducer when the IMT was less than 1.5 mm (P < .05). A generalized linear mixed-effects model analysis showed that the very high-frequency transducer had a greater ability to obtain a valid carotid ultrafast PWV measurement with an IMT of less than 1.5 mm (P < .05). The IMT was positively correlated with the PWV before systole and at the end of systole (r = 0.207-0.771; all P < .05) in the control group, patient group, and carotid subgroup with an IMT of less than 1.5 mm. A multiple regression analysis showed that the IMT and plaque were important independent factors in predicting failure of the ultrafast PWV (P < .001). CONCLUSIONS The ultrafast PWV is an effective and user-friendly method for evaluating carotid stiffness. The IMT and transducer type are factors influencing the ability to obtain an ultrafast PWV measurement.
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Affiliation(s)
- Fu-Shun Pan
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, Guangzhou, China
| | - Liang Yu
- Department of Vascular and Thyroid Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia Luo
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, Guangzhou, China
| | - Ri-Dong Wu
- Department of Vascular and Thyroid Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ming Xu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, Guangzhou, China
| | - Jin-Yu Liang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, Guangzhou, China
| | - Yan-Ling Zheng
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, Guangzhou, China
| | - Xiao-Yan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, Guangzhou, China
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Słomka T, Drelich-Zbroja A, Jarząbek M, Szczerbo-Trojanowska M. Intima-media complex thickness and carotid atherosclerotic plaque formation in Lublin's population in the context of selected comorbidities. J Ultrason 2018; 18:133-139. [PMID: 30335922 PMCID: PMC6440505 DOI: 10.15557/jou.2018.0019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 01/08/2023] Open
Abstract
Introduction: Atherosclerosis (arteriosclerosis) is a chronic arterial disease of the arteries with chronic inflammatory. The pathology of atherosclerosis is complex, and the atherosclerotic process is multi-factorial, not fully understood. Risk factors of atherosclerotic lesions may include: lipid disorders, hypertension or diabetes. One of the diagnostic methods of discovering atherosclerosis covers the assessment of the intima–media complex thickness by Doppler ultrasonography. Aim: The aim of this report was an evaluation of the relationships between intima–media complex thickness in the right and left carotid arteries and the occurrence of atheromatous plaque in the Lublin population with respect to three possible concomitant medical conditions, mentioned above. Material and methods: A group of 121 subjects was included into the study, all of the participants being residential inhabitants of the Lublin Voivodship. All the participating patients were requested to fill in a questionnaire. After that, the patients were submitted to Doppler sonography concentrated on intima–media complex thickness evaluation. The occurrence of atheromatous plaque was also assessed in obtained sonographic images. Results: There were statistically significant differences for the intima–media complex thickness and for the atheromatous plaque according to all of the reported diseases: hypocholesterolaemia, hypertension and diabetes. Conclusions: The present study confirms that there is a relationship between the thickness of the intima–media complex in the right and left carotid arteries as well as the occurrence of the atherosclerotic plaque regarding the coexistence of specific disease entities in the subjects of the Lublin population.
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Affiliation(s)
- Tomasz Słomka
- Department of Information Technology and Medical Statistics, Medical University of Lublin, Poland
| | - Anna Drelich-Zbroja
- Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Poland
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Cecelja M, Jiang B, Keehn L, Hussain T, Silva Vieira M, Phinikaridou A, Greil G, Spector TD, Chowienczyk P. Arterial stiffening is a heritable trait associated with arterial dilation but not wall thickening: a longitudinal study in the twins UK cohort. Eur Heart J 2018; 39:2282-2288. [PMID: 29590330 PMCID: PMC6012080 DOI: 10.1093/eurheartj/ehy165] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/15/2017] [Accepted: 03/07/2018] [Indexed: 01/19/2023] Open
Abstract
Aims Vascular ageing is characterized by arterial stiffening, dilation, and arterial wall thickening. We investigated the extent to which these changes are related and their heritability during 5 year follow-up in the Twins UK cohort. Methods and results Carotid-femoral pulse wave velocity (PWVcf), carotid diameter, carotid distensibility, and carotid intima-media thickness (IMT) were measured in 762 female twins (mean age 57.9 ± 8.6 years) at two time-points over an average follow-up of 4.9 ± 1.5 years. Magnetic resonance imaging (MRI) was performed in a sub-sample of 38 women to measure aortic pulse wave velocity (PWVaorta), diameter, and wall thickness. Heritability of changes in arterial wall properties was estimated using structural equation modelling. Annual increases in PWVcf, carotid diameter, distensibility, and IMT were 0.139 m/s, 0.028 mm, -0.4 kPa-1, and 0.011 mm per year, respectively. In regression analysis, predictors of progression in PWVcf included age, mean arterial pressure (MAP), and heart rate (HR) at baseline, and progression in MAP, HR, and body mass index (BMI). Predictors of progression in IMT included progression in MAP, BMI, and triglyceride levels. Progression of PWV and distensibility correlated with progression in carotid diameter but not with IMT. Heritability of progression of PWVcf, diameter, and IMT was 55%, 21%, and 8%, respectively. In a sub-sample of women that underwent MRI, aortic wall thickness increased by 0.19 mm/year, but aortic wall thickening was not correlated with an increase in lumen diameter or PWVaorta. Conclusion Arterial stiffening, as measured by PWVcf, and dilation are heritable but independent of arterial wall thickening. Genetic and cardiovascular risk factors contribute differently to progression of PWV and IMT.
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Affiliation(s)
- Marina Cecelja
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Benyu Jiang
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Louise Keehn
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Tarique Hussain
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA
| | - Miguel Silva Vieira
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, London, UK
| | - Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, London, UK
| | - Gerald Greil
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
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Effect of physical activity on pulse wave velocity in elderly subjects with normal glucose, prediabetes or Type 2 Diabetes. Sci Rep 2018; 8:8045. [PMID: 29795274 PMCID: PMC5966452 DOI: 10.1038/s41598-018-25755-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/30/2018] [Indexed: 01/26/2023] Open
Abstract
Carotid-femoral pulse wave velocity ((cf)PWV) is a measure of arterial stiffness, predicting cardiovascular disease. We hypothesized that the amount of physical activity (PA) is correlated with reduced arterial stiffness in Type 2 diabetic (T2D) subjects. 570 subjects from the 1945 Oulu birth cohort were included in the analysis. (cf)PWV was determined by a non-invasive applanation tonometry. Oral glucose tolerance test was performed and LDL and HDL cholesterol analyzed. PA was registered daily with a wrist-worn acceleration meter for two weeks. (cf)PWV values in subjects with impaired glucose metabolism (IGM) and T2D were higher than in normal glycemic subjects (P < 0.001). PA, fasting and 2 h glucose and HbA1c correlated significantly with (cf)PWV, but HDL or LDL cholesterol did not. The 2 h glucose, heart rate and alcohol consumption in T2D subjects had independent effects on (cf)PWV in multiple regression analysis. T2D and IGM were significantly associated to (cf)PWV. Interestingly, lipids did not have an additional effect on (cf)PWV. Subjects walking more than 10 000 steps/day had 0.2 m/s lower (cf)PWV than those walking less than 6000 steps/day. Presence of T2D, elevated heart rate and alcohol consumption in males were associated with increased aortic stiffening in elderly subjects.
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Elias MF, Crichton GE, Dearborn PJ, Robbins MA, Abhayaratna WP. Associations between Type 2 Diabetes Mellitus and Arterial Stiffness: A Prospective Analysis Based on the Maine-Syracuse Study. Pulse (Basel) 2018; 5:88-98. [PMID: 29761082 PMCID: PMC5939695 DOI: 10.1159/000479560] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/15/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate prospective associations between type 2 diabetes mellitus status and the gold standard non-invasive method for ascertaining arterial stiffness, carotid femoral pulse wave velocity. METHODS The prospective analysis employed 508 community-dwelling participants (mean age 61 years, 60% women) from the Maine-Syracuse Longitudinal Study. Pulse wave velocity at wave 7 (2006-2010) was compared between those with type 2 diabetes mellitus at wave 6 (2001-2006) (n = 52) and non-diabetics at wave 6 (n = 456), with adjustment for demographic factors, cardiovascular risk factors and lifestyle- and pulse wave velocity-related factors. RESULTS Type 2 diabetes mellitus status was associated with a significantly higher pulse wave velocity (12.5 ± 0.36 vs. 10.4 ± 0.12 m/s). Multivariate adjustment for other cardiovascular risk factors and lifestyle- and pulse wave velocity-related variables did not attenuate the findings. The risk of an elevated pulse wave velocity (≥12 m/s) was over 9 times higher for those with uncontrolled type 2 diabetes mellitus than for those without diabetes (OR 9.14, 95% CI 3.23-25.9, p < 0.001). CONCLUSIONS Type 2 diabetes mellitus, particularly if uncontrolled, is significantly associated with risk of arterial stiffness later in life. Effective management of diabetes mellitus is an important element of protection from arterial stiffness.
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Affiliation(s)
- Merrill F. Elias
- Department of Psychology, University of Maine, Orono, ME, USA
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME, USA
| | - Georgina E. Crichton
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | | | - Michael A. Robbins
- Department of Psychology, University of Maine, Orono, ME, USA
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME, USA
| | - Walter P. Abhayaratna
- College of Medicine, Biology, and Environment, Australian National University, Canberra, ACT, Australia
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Guan Y, Yu C, Shi M, Ni J, Wu Y, Gu H, Bai L, Liu J, Tu J, Wang J, Ning X. The association between elevated fasting plasma glucose levels and carotid intima-media thickness in non-diabetic adults: a population-based cross-sectional study. Oncotarget 2017; 8:111053-111063. [PMID: 29340036 PMCID: PMC5762304 DOI: 10.18632/oncotarget.22302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 10/12/2017] [Indexed: 12/11/2022] Open
Abstract
We assessed the association between the mean carotid intima-media thickness (CIMT) and fasting plasma glucose (FPG) levels in a low-income population in rural China. Adults aged ≥45 years without a history of diabetes, stroke, or cardiovascular disease were recruited. All participants were categorized into four groups according to FPG level. A total of 3509 participants were analyzed in this study. In the univariate analysis, sex, age, education level, hypertension, central obesity, current smoking, alcohol consumption, and higher levels of FPG, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were associated with mean CIMT and frequency of increased CIMT. FPG levels were significantly associated with mean CIMT; each 1-mmol/L increase in FPG resulted in a 2.75-μm increase in mean CIMT when adjusted by age, sex, education level, current smoking status, alcohol consumption, hypertension, and the levels of TC, TG, HDL-C, and LDL-C (P = 0.044). However, the association between FPG and the frequency of increased CIMT disappeared after adjusting by covariates. These findings indicate that FPG is an independent determinant of mean CIMT in a non-diabetic population. Management and control of FPG levels is crucial for preventing atherosclerosis in populations with high stroke risks in China.
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Affiliation(s)
- Yalin Guan
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Changshen Yu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Min Shi
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Jingxian Ni
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Hongfei Gu
- Department of Neurology, Tianjin Haibin People's Hospital, Tianjin, China
| | - Lingling Bai
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Central of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Central of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China
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Tentolouris A, Eleftheriadou I, Grigoropoulou P, Kokkinos A, Siasos G, Ntanasis-Stathopoulos I, Tentolouris N. The association between pulse wave velocity and peripheral neuropathy in patients with type 2 diabetes mellitus. J Diabetes Complications 2017; 31:1624-1629. [PMID: 28893495 DOI: 10.1016/j.jdiacomp.2017.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/08/2017] [Accepted: 07/23/2017] [Indexed: 11/24/2022]
Abstract
AIMS Diabetic peripheral neuropathy (DPN) is the most common diabetic complication, affecting up to half of the patients with type 2 diabetes mellitus (T2DM). Increased aortic stiffness, measured with the carotid-femoral pulse wave velocity (PWV), has been associated with incidence of cardiovascular disease independently of traditional risk factors. Previous data showed associations between risk factors for macroangiopathy and DPN in diabetes. However, the association between PWV and DPN is not well known. In this study we examined the association between PWV and presence as well as severity of DPN in subjects with T2DM. MATERIAL AND METHODS A total of 381 patients with T2DM were recruited. Participants were classified as having DPN and not having DPN. PWV was measured at the carotid-femoral segment with a non-invasive method using applanation tonometry. DPN was assessed by determination of the Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS). RESULTS A hundred and seven participants (28.1%) had DPN. Patients with DPN were significantly more often male and older, had longer diabetes duration, higher height, larger waist circumference, higher systolic arterial blood pressure (SBP) and higher PWV (all P<0.05). Furthermore, participants with DPN were treated more often with statins and had lower low density lipoprotein cholesterol; in addition, they were treated more often with antiplatelets, b-blockers and insulin than those without DPN. Univariative logistic regression analysis demonstrated that presence of DPN was significantly associated with age, male gender, longer diabetes duration, height, waist circumference, SBP, PWV, dyslipidemia, HbA1c, retinopathy, nephropathy and peripheral arterial disease. Multivariate logistic regression analysis, after adjustment for age, gender, waist circumference, SBP, nephropathy and use of b-blockers, demonstrated that the odds [OR (95% confidence intervals)] of peripheral neuropathy were associated significantly and independently only with diabetes duration [1.044 (1.009-1.081), P=0.013], height [1.075 (1.041-1.110), P<0.001], HbA1c [1.468 (1.164-1.851), P<0.001], PWV [1.174 (1.054-1.309), P=0.004], dyslipidemia [1.941 (1.015-3.713), P=0.045], retinopathy [4.426 (2.217-8.837), P<0.001] and peripheral arterial disease [4.658 (2.264-9.584), P<0.001]. In addition, multivariate linear regression analysis, after controlling for age, gender, diabetes duration, SBP, HbA1c and nephropathy, demonstrated that an increased NDS was significantly and independently associated with height [standardized regression coefficient (beta=0.229, P<0.001)], PWV (beta=0.197, P<0.001), retinopathy (beta=0.268, P<0.001) and peripheral arterial disease (beta=0.374, P<0.001). CONCLUSION Increased PWV is associated strongly and independently not only with the presence but also with the severity of DPN in patients with T2DM, irrespective of known risk factors.
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Affiliation(s)
- Anastasios Tentolouris
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Ioanna Eleftheriadou
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Pinelopi Grigoropoulou
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Alexander Kokkinos
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Gerasimos Siasos
- Department of Cardiology, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Nikolaos Tentolouris
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
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Gajdova J, Karasek D, Goldmannova D, Krystynik O, Schovanek J, Vaverkova H, Zadrazil J. Pulse wave analysis and diabetes mellitus. A systematic review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2017. [DOI: 10.5507/bp.2017.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Abstract
OBJECTIVES A reversed aortic-to-brachial stiffness gradient (ab-SG), defined as aortic pulse wave velocity (aPWV) greater than brachial PWV (bPWV), was recently shown to predict mortality independent of aPWV in dialysis patients. Patients with type 2 diabetes mellitus (T2DM) have increased risk of renal damage and exhibit haemodynamic abnormalities at rest and during exercise that may alter the ab-SG. This study aimed to examine ab-SG in patients with T2DM by comparison with nondiabetic controls during rest and exercise, and to determine associations between ab-SG, aPWV, and kidney function. METHODS Study participants were 60 patients with T2DM and 60 age and sex-matched nondiabetic controls (58 ± 8 years, 55% male both). ab-SG was defined as the quotient of bPWV (carotid-to-radial) and aPWV (carotid-to-femoral) recorded via applanation tonometry. Kidney function was assessed using estimated glomerular filtration rate (eGFR). The exercise substudy was undertaken in 21 patients with T2DM and 21 matched nondiabetic controls during semirecumbent exercise. RESULTS ab-SG was significantly lower in patients with T2DM (0.99 ± 0.2 vs. 1.2 ± 0.3, P < 0.001) and aPWV, but not bPWV, was significantly higher (P < 0.001 and P = 0.25). A total of 58% of patients with T2DM vs. 27% of nondiabetic controls (χ = 11.0, P < 0.001) had a reversed ab-SG (aPWV ≥ bPWV). ab-SG predicted eGFR independent of age, sex, T2DM status, and cardiovascular risk factors (β = 13.2, P = 0.024), whereas aPWV did not (β = -0.88, P = 0.30). Exercise ab-SG was significantly lower in patients with T2DM (0.97 ± 0.2 vs. 1.2 ± 0.2, P < 0.001), but did not predict eGFR. CONCLUSIONS Patients with T2DM have a reversed ab-SG during rest and exercise. Resting ab-SG predicts kidney function independent of aPWV, implying a reversed ab-SG may have a pathophysiological function.
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Adenwalla SF, Graham-Brown MPM, Leone FMT, Burton JO, McCann GP. The importance of accurate measurement of aortic stiffness in patients with chronic kidney disease and end-stage renal disease. Clin Kidney J 2017; 10:503-515. [PMID: 28852490 PMCID: PMC5570016 DOI: 10.1093/ckj/sfx028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/21/2017] [Indexed: 12/27/2022] Open
Abstract
Cardiovascular (CV) disease is the leading cause of death in chronic kidney disease (CKD) and end-stage renal disease (ESRD). A key driver in this pathology is increased aortic stiffness, which is a strong, independent predictor of CV mortality in this population. Aortic stiffening is a potentially modifiable biomarker of CV dysfunction and in risk stratification for patients with CKD and ESRD. Previous work has suggested that therapeutic modification of aortic stiffness may ameliorate CV mortality. Nevertheless, future clinical implementation relies on the ability to accurately and reliably quantify stiffness in renal disease. Pulse wave velocity (PWV) is an indirect measure of stiffness and is the accepted standard for non-invasive assessment of aortic stiffness. It has typically been measured using techniques such as applanation tonometry, which is easy to use but hindered by issues such as the inability to visualize the aorta. Advances in cardiac magnetic resonance imaging now allow direct measurement of stiffness, using aortic distensibility, in addition to PWV. These techniques allow measurement of aortic stiffness locally and are obtainable as part of a comprehensive, multiparametric CV assessment. The evidence cannot yet provide a definitive answer regarding which technique or parameter can be considered superior. This review discusses the advantages and limitations of non-invasive methods that have been used to assess aortic stiffness, the key studies that have assessed aortic stiffness in patients with renal disease and why these tools should be standardized for use in clinical trial work.
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Affiliation(s)
- Sherna F Adenwalla
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Matthew P M Graham-Brown
- John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK.,National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Francesca M T Leone
- College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - James O Burton
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.,John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK.,Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
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Fourie CMT, Schutte AE. Early vascular aging in the HIV infected: Is arterial stiffness assessment the ideal tool? Virulence 2017; 8:1075-1077. [PMID: 28467147 DOI: 10.1080/21505594.2017.1325984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Carla M T Fourie
- a Hypertension in Africa Research Team (HART) , North-West University , Potchefstroom , South Africa.,b MRC Unit for Hypertension and Cardiovascular Disease , North-West University , Potchefstroom , South Africa
| | - Aletta E Schutte
- a Hypertension in Africa Research Team (HART) , North-West University , Potchefstroom , South Africa.,b MRC Unit for Hypertension and Cardiovascular Disease , North-West University , Potchefstroom , South Africa
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Hamamura M, Mita T, Osonoi Y, Osonoi T, Saito M, Tamasawa A, Nakayama S, Someya Y, Ishida H, Gosho M, Kanazawa A, Watada H. Relationships Among Conventional Cardiovascular Risk Factors and Lifestyle Habits With Arterial Stiffness in Type 2 Diabetic Patients. J Clin Med Res 2017; 9:297-302. [PMID: 28270889 PMCID: PMC5330772 DOI: 10.14740/jocmr2870w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 11/21/2022] Open
Abstract
Background While conventional cardiovascular risk factors and certain lifestyle habits are associated with arterial stiffness in patients with type 2 diabetes mellitus (T2DM), it is still unknown whether they are actually associated with arterial stiffness even after adjustment for conventional cardiovascular risk factors and lifestyle habits. The aim of this study was to identify variables that are associated with brachial-ankle pulse wave velocity (baPWV). Methods The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. Lifestyle habits were analyzed using self-reported questionnaires. The associations among conventional cardiovascular risk factors and lifestyle habits with baPWV were investigated by multivariable linear regression analysis. Results The mean age of the study subjects was 57.8 ± 8.6 years, and 62.8% of those were males. The mean HbA1c was 7.0±1.0%, and the estimated duration of T2DM was 9.9 ± 7.2 years. Multiple linear regression analysis that included age and gender demonstrated that age and male sex were positively associated with baPWV. In a model adjusted for numerous conventional cardiovascular risk factors and lifestyle habits, age, duration of T2DM, systolic blood pressure, serum uric acid, urinary albumin excretion and poor sleep quality were positively associated with baPWV, while body mass index was negatively associated with baPWV. Conclusions In Japanese T2DM, in addition to several conventional cardiovascular risk factors, poor sleep quality was associated with baPWV even after adjustment for numerous conventional cardiovascular risk factors and lifestyle habits.
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Affiliation(s)
- Misako Hamamura
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Tomoya Mita
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Yusuke Osonoi
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Takeshi Osonoi
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Miyoko Saito
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Atsuko Tamasawa
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Shiho Nakayama
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Yuki Someya
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Hidenori Ishida
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Akio Kanazawa
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
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Affiliation(s)
- Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital
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50
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Cardoso CRL, Salles GF. Aortic Stiffness as a Surrogate Endpoint to Micro- and Macrovascular Complications in Patients with Type 2 Diabetes. Int J Mol Sci 2016; 17:2044. [PMID: 27929441 PMCID: PMC5187844 DOI: 10.3390/ijms17122044] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/27/2016] [Accepted: 11/29/2016] [Indexed: 12/22/2022] Open
Abstract
Increased aortic stiffness has been recognized as a predictor of adverse cardiovascular outcomes in some clinical conditions, such as in patients with arterial hypertension and end-stage renal disease, in population-based samples and, more recently, in type 2 diabetic patients. Patients with type 2 diabetes have higher aortic stiffness than non-diabetic individuals, and increased aortic stiffness has been correlated to the presence of micro- and macrovascular chronic diabetic complications. We aimed to review the current knowledge on the relationships between aortic stiffness and diabetic complications, their possible underlying physiopathological mechanisms, and their potential applications to clinical type 2 diabetes management.
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Affiliation(s)
- Claudia R L Cardoso
- Department of Internal Medicine, School of Medicine and University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco 255, Cidade Universitária, Rio de Janeiro-RJ 21941-901, Brazil.
| | - Gil F Salles
- Department of Internal Medicine, School of Medicine and University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco 255, Cidade Universitária, Rio de Janeiro-RJ 21941-901, Brazil.
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