title: Impact of ADMA, endothelial progenitor cells and traditional cardiovascular risk factors on pulse wave velocity among prediabetic individuals.
abstract: BACKGROUND
  Central arterial stiffness represents a well-established predictor of cardiovascular disease. Decreased circulating endothelial progenitor cells (EPCs), increased asymmetric dimethyl-arginine (ADMA) levels, traditional cardiovascular risk factors and insulin resistance have all been associated with increased arterial stiffness. The correlations of novel and traditional cardiovascular risk factors with central arterial stiffness in prediabetic individuals were investigated in the present study.
  
  
  METHODS
  The study population consisted of 53 prediabetic individuals. Individuals were divided into groups of isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT) and combined IGT-IFG. Age, sex, family history of diabetes, smoking history, body mass index (BMI), waist to hip ratio (WHR), waist circumference (WC), blood pressure, lipid profile, levels of high sensitive C-reactive protein (hsCRP), glomerular filtration rate (GFR), and history of antihypertensive or statin therapy were obtained from all participants. Insulin resistance was evaluated using the Homeostatic Model Assessment (HOMA-IR). Carotid -femoral pulse wave velocity was used as an index of arterial stiffness. Circulating EPC count and ADMA serum levels were also determined.
  
  
  RESULTS
  Among studied individuals 30 (56.6%) subjects were diagnosed with isolated IFG, 9 (17%) with isolated IGT (17%) and 14 with combined IFG-IGT (26.4%). In univariate analysis age, mean blood pressure, fasting glucose, total cholesterol, LDL cholesterol, and ADMA levels positively correlated with pulse-wave velocity while exercise and GFR correlated negatively. EPC count did not correlate with PWV. In multivariate stepwise regression analysis PWV correlated independently and positively with LDL-Cholesterol (low density lipoprotein) and ADMA levels and negatively with exercise.
  
  
  CONCLUSIONS
  Elevated ADMA and LDL-C levels are strongly associated with increased arterial stiffness among pre-diabetic subjects. In contrast exercise inversely correlated with arterial stiffness.
authors.affiliation: Diabetes Center, Tzanio General Hospital of Piraeus, Zanni and Afendouli 1, Piraeus 18537, Greece. ioprot@gmail.com
authors.forename: Ioannis
authors.initials: I
authors.lastname: Protopsaltis
authors.forename: Stefanos
authors.initials: S
authors.lastname: Foussas
authors.forename: Angeliki
authors.initials: A
authors.lastname: Angelidi
authors.forename: Angelos
authors.initials: A
authors.lastname: Gritzapis
authors.forename: Theodoros Ν
authors.initials: TΝ
authors.lastname: Sergentanis
authors.forename: Spyros
authors.initials: S
authors.lastname: Matsagos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tzirogiannis
authors.forename: Georgios I
authors.initials: GI
authors.lastname: Panoutsopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Dimitriadis
authors.forename: Sotirios
authors.initials: S
authors.lastname: Raptis
authors.forename: Andreas
authors.initials: A
authors.lastname: Melidonis
mesh_terms: D000328:Adult; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D002339:Carotid Arteries / Q000503:physiopathology*; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D042783:Endothelial Cells / Q000378:metabolism*; D005215:Fasting / Q000097:blood; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011236:Prediabetic State / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013234:Stem Cells / Q000378:metabolism*; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008078:Cholesterol, LDL; C018524:N,N-dimethylarginine; D001120:Arginine