title: Associations between cardio-ankle vascular index and microvascular complications in type 2 diabetes mellitus patients.
abstract: OBJECTIVE
  Type 2 diabetes mellitus (T2DM) is a risk factor for increased arterial stiffness. We evaluated associations between the cardio-ankle vascular index (CAVI) and carotid plaque, intima media thickness (IMT), and diabetic microvascular complications in Korean T2DM patients.
  
  
  METHODS
  We conducted a retrospective, cross-sectional study of 320 Korean T2DM patients without a history of macrovascular disease or macroalbuminuria. We measured 24-hour urinary albumin excretion (UAE) levels and performed funduscopic and neuropathy examinations to assess the extent of diabetic microvascular complications. Arterial stiffness was assessed using CAVI. We also measured the ankle-brachial index (ABI), common carotid artery IMT, and carotid beta stiffness index.
  
  
  RESULTS
  Among the 320 patients enrolled in this study, 64 (20%) had increased CAVI (≥ 9). We found that CAVI was correlated with systolic blood pressure, pulse pressure, IMT, carotid beta stiffness index, log-transformed UAE, and total cholesterol. In multiple logistic regression analysis, mean IMT and the presence of carotid plaque were independently associated with increased CAVI (≥ 9) (OR=5.77, P < 0.01; OR=5.36, P < 0.001, respectively). Furthermore, an increased CAVI was associated with peripheral neuropathy (OR=2.03, P = 0.03) and microalbuminuria (OR=2.47, P < 0.01) after adjusting for possible confounding variables.
  
  
  CONCLUSIONS
  The results of this study suggest that increased CAVI is associated with the presence of arterial plaque, increased IMT, and microvascular complications, such as nephropathy and neuropathy, in T2DM patients.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kwang Joon
authors.initials: KJ
authors.lastname: Kim
authors.forename: Byung-Wan
authors.initials: BW
authors.lastname: Lee
authors.forename: Hyun-Min
authors.initials: HM
authors.lastname: Kim
authors.forename: Joo Youn
authors.initials: JY
authors.lastname: Shin
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Kang
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Cha
authors.forename: Eun Jig
authors.initials: EJ
authors.lastname: Lee
authors.forename: Sung-Kil
authors.initials: SK
authors.lastname: Lim
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index / Q000706:statistics & numerical data; D002340:Carotid Artery Diseases / Q000473:pathology; D003430:Cross-Sectional Studies; D056911:Democratic People's Republic of Korea / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000473:pathology*; D003928:Diabetic Nephropathies; D006801:Humans; D008833:Microcirculation; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D012189:Retrospective Studies; D017539:Tunica Intima / Q000473:pathology; D014652:Vascular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology