title: Arterial stiffness is associated with incident albuminuria and decreased glomerular filtration rate in type 2 diabetic patients.
abstract: OBJECTIVE
  To investigate the association between aortic stiffness and incident albuminuria and the decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes.
  
  
  METHODS
  We investigated 461 Japanese type 2 diabetic patients, comprising 199 women and 262 men, with a mean age of 59 ± 11 years. Patients were divided into two groups according to the median value of carotid-femoral pulse wave velocity (cf-PWV), which was used to evaluate aortic stiffness. The end point was defined as the transition from normo- to microalbuminuria or micro- to macroalbuminuria. The Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95% CI. The correlation between cf-PWV and rate of change in eGFR was also determined by linear regression analysis.
  
  
  RESULTS
  The baseline mean (± SD) cf-PWV was 9.6 ± 2.4 m/s. During a median follow-up period of 5.9 years (range 0.3-8.6), progression of albuminuria was observed in 85 patients. The 5-year cumulative incidence of the end point in patients with cf-PWV below and above the median was 8.5 and 19.4%, respectively (P = 0.002, log-rank test). cf-PWV was significantly associated with incident albuminuria (HR 1.23, 95% CI 1.13-1.33, P < 0.001) by multivariate Cox regression analysis. A significant association between cf-PWV and annual change in eGFR was also suggested by multiple linear regression analysis (standardized estimate -0.095, P = 0.031).
  
  
  CONCLUSIONS
  Aortic stiffness is associated with incident albuminuria and the rate of decline in glomerular filtration rate in type 2 diabetic patients.
authors.affiliation: Division of Nephrology and Hypertension, Diabetes Center, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Bouchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Babazono
authors.forename: Michino
authors.initials: M
authors.lastname: Mugishima
authors.forename: Naoshi
authors.initials: N
authors.lastname: Yoshida
authors.forename: Izumi
authors.initials: I
authors.lastname: Nyumura
authors.forename: Kiwako
authors.initials: K
authors.lastname: Toya
authors.forename: Ko
authors.initials: K
authors.lastname: Hanai
authors.forename: Nobue
authors.initials: N
authors.lastname: Tanaka
authors.forename: Akiko
authors.initials: A
authors.lastname: Ishii
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Uchigata
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000209:etiology*; D001011:Aorta / Q000503:physiopathology; D044466:Asian People; D001783:Blood Flow Velocity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011673:Pulsatile Flow; D059289:Vascular Stiffness