Prediabetes and Diabetes Are Associated With Arterial Stiffness in Older Adults: The ARIC Study.

Autor:	Loehr LR; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; lloehr@email.unc.edu., Meyer ML; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;, Poon AK; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;, Selvin E; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA;, Palta P; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;, Tanaka H; University of Texas at Austin, Austin, Texas, USA;, Pankow JS; University of Minnesota, Minneapolis, Minnesota, USA;, Wright JD; National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA;, Griswold ME; University of Mississippi Medical Center, Jackson, Mississippi, USA;, Wagenknecht LE; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA., Heiss G; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
Jazyk:	angličtina
Zdroj:	American journal of hypertension [Am J Hypertens] 2016 Sep; Vol. 29 (9), pp. 1038-45. Date of Electronic Publication: 2016 Apr 11.
DOI:	10.1093/ajh/hpw036
Abstrakt:	Background: To determine whether prediabetes and diabetes in older adults are associated with arterial stiffness measured in central and peripheral arteries and to examine characteristics that modify these associations. Methods: Cohort members attending the 5th exam (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) study had pulse wave velocity (PWV) measures performed at the carotid-femoral (cfPWV), brachial-ankle (baPWV), and femoral-ankle (faPWV) segments. Fasting glucose ≥126mg/dl, glycated hemoglobin (HbA1c) ≥6.5%, or currently taking diabetes medication defined diabetes. Fasting glucose 100-125mg/dl or HbA1c 5.7%-6.4% among those without diabetes defined prediabetes. Cross-sectional associations were modeled using multivariable linear regression. Results: Among 4,279 eligible participants with cfPWV measures (mean age 75 years), 22% were African-American, 25.5% had diabetes, and 54.7% had prediabetes. Compared to those with normal glucose, cfPWV was 95.8cm/s higher (stiffer) on average for those with diabetes (for reference: being 1 year older was associated with 14.4cm/s higher cfPWV). Similar findings were seen for diabetes and baPWV, although attenuated. Interestingly, faPWV was 17.6cm/s lower for those with diabetes compared to normal glucose. There was a significant positive association between baPWV and prediabetes. Among those with diabetes, cfPWV was higher for those with albuminuria, reduced kidney function, duration of diabetes ≥10 years, and elevated HbA1c (HbA1c ≥7). Conclusion: Among older adults, diabetes is associated with higher central arterial stiffness and lower peripheral arterial stiffness, and prediabetes is associated with higher baPWV. Cross-sectionally, the magnitude of the effect of diabetes on central stiffness is equivalent to 6 years of arterial aging. (© American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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