Climie Rachel E, Rehman S, Brunner E J, Boutouyrie P, Bruno R M, Empana J P
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (R.E.C., S.R.).
Institut national de la santé et de la recherche médicale, Pars Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease Team, Université Paris Cité, France (R.E.C., P.B., R.M.B., J.P.E.).
Arterioscler Thromb Vasc Biol. 2025 Aug;45(8):1459-1467. doi: 10.1161/ATVBAHA.124.322001. Epub 2025 Jun 19.
Type 2 diabetes is associated with elevated large artery stiffening, but arterial stiffening may also precede the development of type 2 diabetes. Whether the change in arterial stiffness over time is associated with dysglycemia across the entire spectrum of blood glucose concentration is unknown. Therefore, the primary objective of this study was to quantify the association between the change in arterial stiffness (exposure) and glycemic concentration (outcome).
Within the prospective WHS II (Whitehall II Study), arterial stiffness was first measured in the 2007/09 examination round (baseline for the current study) and again in 2012/13, using the noninvasive, gold-standard method of carotid to femoral pulse wave velocity (cfPWV). Change in cfPWV was determined as cfPWV in 2012/13-cfPWV-cfPWV in 2007/09. Fasting blood glucose concentrations were measured at baseline (2007/09) and follow-up in 2012/13 and 2015/16.
There were 2632 participants without prior type 2 diabetes and cfPWV measured at 2 timepoints with follow-up in 2012/13 and 2282 with follow-up in 2015/16. Greater change in cfPWV was associated with significantly higher fasting glucose concentration at follow-up in 2012/13 and 2015/16 independently of confounders including cfPWV and fasting glucose levels at baseline (<0.001 for both). Greater change in cfPWV was significantly and independently associated with a greater change in fasting glucose concentration over the same period (2007/09-2012/13) and beyond (2007/09-2015/16).
Minimizing premature arterial stiffening over time could be a valuable strategy for the prevention of glucose dysregulation and overt type 2 diabetes.
2型糖尿病与大动脉僵硬度升高有关，但动脉僵硬度也可能在2型糖尿病发生之前出现。动脉僵硬度随时间的变化是否与血糖浓度全谱范围内的血糖异常有关尚不清楚。因此，本研究的主要目的是量化动脉僵硬度变化（暴露因素）与血糖浓度（结果）之间的关联。
在前瞻性的怀特霍尔二期研究（WHS II）中，于2007/09检查轮次（本研究的基线）首次测量动脉僵硬度，并于2012/13再次测量，采用无创的金标准方法——颈动脉至股动脉脉搏波速度（cfPWV）。cfPWV的变化定义为2012/13年的cfPWV减去2007/09年的cfPWV。在基线（2007/09）以及2012/13和2015/16的随访中测量空腹血糖浓度。
共有2632名无2型糖尿病病史的参与者在两个时间点测量了cfPWV，并在2012/13进行随访，2282名参与者在2015/16进行随访。cfPWV的更大变化与2012/13和2015/16随访时显著更高的空腹血糖浓度相关，独立于包括基线时的cfPWV和空腹血糖水平在内的混杂因素（两者均P<0.001）。cfPWV的更大变化与同期（2007/09 - 2012/13）及之后（2007/09 - 2015/16）空腹血糖浓度的更大变化显著且独立相关。
随着时间的推移尽量减少过早的动脉僵硬度可能是预防血糖失调和显性2型糖尿病的一项有价值的策略。
