Nuamchit Teonchit, Siriwittayawan Duangduan, Thitiwuthikiat Piyanuch
Department of Cardiothoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.
Vasc Health Risk Manag. 2020 Aug 25;16:343-352. doi: 10.2147/VHRM.S265157. eCollection 2020.
The impact of glycemic control on macrovascular complications and arterial stiffness in type II diabetes (T2D), as well as the extent of additive effect of hypertension, is unclear. The aims of this study were to investigate the impact of glycemic control on the cardio-ankle vascular index (CAVI), an indicator of arterial stiffness, and to determine the relative risk of concomitant diabetes and hypertension with arterial stiffness.
One hundred and nine participants were enrolled and classified as non-diabetes (n= 37) and diabetes (n=72); the diabetic group was further identified as controllable and uncontrollable T2D depending on their hemoglobin A1c (HbA1c) levels. Univariate and multiple regression analyses were used to assess the association between CAVI and glycemic control status and hypertension. Relative risk analysis for abnormal CAVI with exposure to diabetes and hypertension was investigated.
In all participants, age, systolic blood pressure, body mass index, and fasting blood sugar were independent predictors of CAVI. In diabetic participants, glycemic control status or HbA1c levels did not significantly correlate with CAVI. Systolic blood pressure was an independent predictor for CAVI with = 0.26. In addition, the coexistence of diabetes together with hypertension was significantly associated with a 2.4-fold increase in the risk of abnormal CAVI (95% CI, 1.410-4.184; <0.001).
This study demonstrates that HbA1c as well as fasting blood sugar levels in diabetic participants do not correlate with arterial stiffness. Concomitant diabetes and hypertension significantly increase the risk of arterial stiffness.
血糖控制对2型糖尿病(T2D)大血管并发症和动脉僵硬度的影响,以及高血压的附加作用程度尚不清楚。本研究的目的是调查血糖控制对作为动脉僵硬度指标的心脏-脚踝血管指数(CAVI)的影响,并确定糖尿病和高血压合并存在时动脉僵硬度的相对风险。
招募了109名参与者,分为非糖尿病组(n = 37)和糖尿病组(n = 72);糖尿病组根据糖化血红蛋白(HbA1c)水平进一步分为可控T2D组和不可控T2D组。采用单因素和多因素回归分析评估CAVI与血糖控制状态及高血压之间的关联。对暴露于糖尿病和高血压的异常CAVI进行相对风险分析。
在所有参与者中,年龄、收缩压、体重指数和空腹血糖是CAVI的独立预测因素。在糖尿病参与者中,血糖控制状态或HbA1c水平与CAVI无显著相关性。收缩压是CAVI的独立预测因素,β = 0.26。此外,糖尿病与高血压并存与异常CAVI风险增加2.4倍显著相关(95%CI,1.410 - 4.184;P<0.001)。
本研究表明,糖尿病参与者的HbA1c以及空腹血糖水平与动脉僵硬度无关。糖尿病与高血压并存显著增加动脉僵硬度风险。