title: Increased aortic stiffness measured by MRI in patients with type 1 diabetes mellitus and relationship to renal function.
abstract: OBJECTIVE
  Arterial stiffness is an important predictor of cardiovascular disease in type 1 diabetes mellitus (DM). The purpose of this study was to investigate whether type 1 DM is associated with increased aortic stiffness as measured by MRI, independently of renal dysfunction, and to evaluate the relationship between aortic stiffness and renal function within the normal range in patients with type 1 DM.
  
  
  METHODS
  We included 77 patients with type 1 DM (mean age, 46 ± 12 years) and 36 healthy control subjects matched for age and renal function in a cross-sectional study. Exclusion criteria consisted of microalbuminuria, renal impairment, aortic valve disease, and standard MRI contraindications. Aortic pulse wave velocity (PWV), a marker of aortic stiffness, was assessed by MRI. Renal function was expressed as the estimated glomerular filtration rate (GFR). Mann-Whitney U test and Spearman's correlation analysis were performed. Stepwise multivariable logarithmic regressions with forward entry analysis for estimated GFR were performed to study the relationship with aortic PWV using interaction terms for type 1 DM.
  
  
  RESULTS
  Patients with type 1 DM without microalbuminuria or renal impairment show increased aortic PWV compared with control subjects (p < 0.05). There was a statistically significant correlation between estimated GFR and aortic PWV in patients with type 1 DM (p < 0.001; r = -0.427) and control subjects (p = 0.002; r = -0.502), with aortic PWV being increased in patients with type 1 DM for each given estimated GFR within the normal range (p < 0.001). The decrease in estimated GFR per increase in aortic PWV was similar for patients with type 1 DM and control subjects (p, not significant).
  
  
  CONCLUSIONS
  Our data show that aortic stiffness, as measured by MRI, is increased and inversely related to renal function in patients with type 1 DM with normal albuminuria and normal estimated GFR.
authors.affiliation: Department of Radiology, Leiden University Medical Center, The Netherlands. s.g.c.van_elderen@lumc.nl
authors.forename: Saskia G C
authors.initials: SG
authors.lastname: van Elderen
authors.forename: Jos J M
authors.initials: JJ
authors.lastname: Westenberg
authors.forename: Anne
authors.initials: A
authors.lastname: Brandts
authors.forename: Rutger W
authors.initials: RW
authors.lastname: van der Meer
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
mesh_terms: D001018:Aortic Diseases / Q000503:physiopathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D018709:Statistics, Nonparametric