Augmentation pressure and subendocardial viability ratio are associated with microalbuminuria and with poor renal function in type 1 diabetes.
In this report we explore the hypothesis that arterial stiffness indices, which predict cardiovascular disease, might also correlate with microalbuminuria (MA) in type 1 diabetes (T1D), and thus have potential for risk assessment. Three pulse wave analysis (PWA) indices, measured using the SphygmoCor device, were evaluated on 144 participants with childhood-onset T1D. These variables, augmentation index (AIx), augmentation pressure (AP) and subendocardial viability ratio (SEVR, an estimate of myocardial perfusion) (an estimate of myocardial perfusion), were each analysed cross-sectionally in relation to both prevalent MA (defined as albuminuria excretion rate (AER) = 20-199 microg/min) and renal function (assessed by both eGFR and serum cystatin C). AP and SEVR were each univariately associated with AER, estimated glomerular filtration rate (eGFR) and cystatin C. Lower SEVR was also independently related to the presence of MA and degree of albuminuria within normo- and microalbuminuric participants. SEVR, not AP, was independently and negatively associated with both measures of renal function. SEVR is a better predictor of AER than brachial blood pressure measures in those without clinical proteinuria, indicating a potential use for PWA in the early detection of individuals at risk for cardiovascular and renal complications of T1D.
Prince
Catherine T
CT
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 3512 Fifth Avenue, Pittsburgh, PA 15213, USA.
Secrest
Aaron M
AM
Mackey
Rachel H
RH
Arena
Vincent C
VC
Kingsley
Lawrence A
LA
Orchard
Trevor J
TJ
D000328:Adult; D000419:Albuminuria / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D016009:Chi-Square Distribution; D003326:Coronary Circulation; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D018450:Disease Progression; D004548:Elasticity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D016017:Odds Ratio; D010414:Pennsylvania; D018570:Risk Assessment; D012307:Risk Factors; D019722:Sphygmomanometers; D013997:Time Factors
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C