Associations of metabolic variables with arterial stiffness in type 2 diabetes mellitus: focus on insulin sensitivity and postprandial triglyceridaemia.
BACKGROUND
Type 2 diabetes mellitus is associated with an increased risk of atherothrombotic disease, which may in part be mediated through increased arterial stiffness. We investigated to what extent increased arterial stiffness is associated with cardiovascular risk factors that commonly cluster in type 2 diabetes.


METHODS
In this cross-sectional, observational study we assessed, in 81 subjects with type 2 diabetes, local distensibility and compliance of the common carotid and femoral arteries, and carotido-femoral transit time. We subsequently investigated whether these measures of arterial stiffness were determined by diabetes duration, blood pressure, lipid levels (including fasting and postprandial triglyceridaemia), hyperglycaemia, BMI, waist-to-hip ratio, insulin resistance (as measured by a euglycaemic, hyperinsulinaemic clamp), hyperinsulinaemia, cigarette smoking, or the use of alcohol.


RESULTS
In multivariate analysis, insulin-mediated glucose uptake was positively [standardized beta, 0.21 (P = 0.05)] associated with the carotid artery compliance coefficient, and the use of alcohol was negatively associated with the femoral artery compliance coefficient [standardized beta, -0.25 (P = 0.03)]. Except for mean arterial pressure, which was negatively associated with all outcome variables, the other cardiovascular risk factors that we investigated were not significantly associated with the distensibility coefficients of both the carotid and femoral artery, or with the carotido-femoral transit time.


CONCLUSIONS
In subjects with type 2 diabetes mellitus, insulin resistance and the use of alcohol were associated with increased arterial stiffness, which supports the hypothesis that increased arterial stiffness can act as a mediating factor in the association between type 2 diabetes mellitus and increased risk of atherothrombotic disease. We found no evidence for an association between fasting or postprandial triglyceridaemia and arterial stiffness.
van Dijk
R A J M
RA
Vrije Universiteit Medical Center, Amsterdam, The Netherlands. rajm.vandijk@vumc.nl
Bakker
S J L
SJ
Scheffer
P G
PG
Heine
R J
RJ
Stehouwer
C D A
CD
D001158:Arteries / Q000378:metabolism*; D001916:Brachial Artery / Q000378:metabolism; D017536:Carotid Artery, Common / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D003925:Diabetic Angiopathies / Q000378:metabolism*; D005260:Female; D005263:Femoral Artery / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism; D015228:Hypertriglyceridemia / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D014655:Vascular Resistance / Q000502:physiology*