[Effects of age on the relationship between cardio-ankle vascular index and atherosclerotic progression in patients with type 2 diabetes mellitus].
OBJECTIVE
A new indicator of arterial stiffness, cardio-ankle vascular index (CAVI), has recently been developed, instead of conventional pulse wave velocity. CAVI is proposed as a blood pressure-independent indicator of atherosclerosis, however, there have been few studies on the association of CAVI with atherosclerosis. The purpose of this study was to investigate effects of age on the relationship between CAVI and atherosclerotic risk in patients with diabetes mellitus.


METHODS
The relationship between CAVI and atherosclerotic risk was investigated in 105 subjects with type 2 diabetes mellitus (mean age, 65.1 years old). The mean intima-media thickness (IMT) of the carotid artery was used as an indicator of atherosclerotic progression.


RESULTS
In 55.2% of the subjects, CAVI was abnormally high (> or =9.0). In simple regression analysis, CAVI showed significant correlations with age, duration of diabetes and IMT. In logistic regression analysis, crude odds of abnormally high values of CAVI were significant for highest versus lowest tertile groups of mean arterial pressure (MAP) and IMT. Age-and sex-adjusted odds of abnormally high values of CAVI were significant for highest versus lowest tertile groups of mean arterial pressure (MAP) and serum total cholesterol. In multiple regression analysis, CAVI showed significant correlation with IMT independently of MAP but not independently of age, while the significant correlation of ankle-brachial pressure index (ABPI) with IMT was independent of age, sex and MAP.


CONCLUSIONS
CAVI reflects atherosclerotic risk and the relationship between CAVI and atherosclerotic progression is strongly confounded by age. Thus, age should be taken into account when CAVI is used as an indicator of atherosclerotic progression.
Wakabayashi
Ichiro
I
Department of Hygiene and Preventive Medicine, Yamagata University School of Medicine.
Masuda
Hirosi
H