TY - JOUR
T1 - The systolic-diastolic difference in carotid stiffness is increased in type 2 diabetes
T2 - The Maastricht Study
AU - Veugen, Marja G. J.
AU - Henry, Ronald M. A.
AU - van Sloten, Thomas T.
AU - Hermeling, Evelien
AU - Brunner-La Rocca, Hans-Peter
AU - Schram, Miranda T.
AU - Dagnelie, Pieter C.
AU - Schalkwijk, Casper G.
AU - Kroon, Abraham A.
AU - Stehouwer, Coen D. A.
AU - Reesink, Koen D.
PY - 2017/5
Y1 - 2017/5
N2 - Objective: In type 2 diabetes (T2D), increased arterial stiffening results from accelerated arterial wall matrix remodeling. The associated structural alterations modify the pressure dependency of arterial stiffness, which can be quantified by the systolic-diastolic difference in carotid pulse wave velocity (delta PWV). We evaluated the association between T2D and dPWV as marker for matrix remodeling and whether dPWV may contain additional information beyond carotid stiffness (cPWV).Methods: In 746 individuals from The Maastricht Study, 415 with normal glucose metabolism; 126 with prediabetes; and 205 with T2D, carotid pulse wave velocity (cPWV) and dPWV were determined by ultrasonography and tonometry. Multiple linear regression analyses were used to investigate associations of glucose metabolism status (with normal glucose metabolism as reference) with cPWV and dPWV, adjusting for age, sex, mean arterial pressure, prior cardiovascular disease, estimated glomerular filtration rate and smoking, and dPWV or cPWV as appropriate.Results: After adjustment for age, sex, mean arterial pressure, prior cardiovascular disease, estimated glomerular filtration rate and smoking, T2D was associated with greater cPWV [beta(95% confidence interval) 0.376 (0.119; 0.632)] and delta PWV [0.301 (0.013; 0.589)]. After additional adjustment for dPWV or cPWV, associations of T2D with cPWV and dPWV were attenuated [0.294 (0.048; 0.539) and 0.173 (-0.103; 0.449), respectively]. Prediabetes was not associated with either cPWV or dPWV.Conclusion: The systolic-diastolic difference in carotid stiffness is increased in T2D, but not prediabetes. Importantly, the association was not abolished by carotid stiffness, which suggests that systolic-diastolic difference in carotid stiffness carries additional information regarding arterial matrix remodeling.
AB - Objective: In type 2 diabetes (T2D), increased arterial stiffening results from accelerated arterial wall matrix remodeling. The associated structural alterations modify the pressure dependency of arterial stiffness, which can be quantified by the systolic-diastolic difference in carotid pulse wave velocity (delta PWV). We evaluated the association between T2D and dPWV as marker for matrix remodeling and whether dPWV may contain additional information beyond carotid stiffness (cPWV).Methods: In 746 individuals from The Maastricht Study, 415 with normal glucose metabolism; 126 with prediabetes; and 205 with T2D, carotid pulse wave velocity (cPWV) and dPWV were determined by ultrasonography and tonometry. Multiple linear regression analyses were used to investigate associations of glucose metabolism status (with normal glucose metabolism as reference) with cPWV and dPWV, adjusting for age, sex, mean arterial pressure, prior cardiovascular disease, estimated glomerular filtration rate and smoking, and dPWV or cPWV as appropriate.Results: After adjustment for age, sex, mean arterial pressure, prior cardiovascular disease, estimated glomerular filtration rate and smoking, T2D was associated with greater cPWV [beta(95% confidence interval) 0.376 (0.119; 0.632)] and delta PWV [0.301 (0.013; 0.589)]. After additional adjustment for dPWV or cPWV, associations of T2D with cPWV and dPWV were attenuated [0.294 (0.048; 0.539) and 0.173 (-0.103; 0.449), respectively]. Prediabetes was not associated with either cPWV or dPWV.Conclusion: The systolic-diastolic difference in carotid stiffness is increased in T2D, but not prediabetes. Importantly, the association was not abolished by carotid stiffness, which suggests that systolic-diastolic difference in carotid stiffness carries additional information regarding arterial matrix remodeling.
KW - arterial stiffness
KW - collagen crosslinking
KW - elastin degradation
KW - pulse wave velocity
KW - vascular remodeling
KW - IMPAIRED FASTING GLUCOSE
KW - PULSE-WAVE VELOCITY
KW - ARTERIAL STIFFNESS
KW - BLOOD-PRESSURE
KW - CROSS-LINKING
KW - CARDIOVASCULAR-DISEASE
KW - CLINICAL-APPLICATIONS
KW - AORTIC STIFFNESS
KW - EUROPEAN-SOCIETY
KW - CARDIOLOGY ESC
U2 - 10.1097/HJH.0000000000001298
DO - 10.1097/HJH.0000000000001298
M3 - Article
C2 - 28355169
SN - 0263-6352
VL - 35
SP - 1052
EP - 1060
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 5
ER -