Peripheral arterial stiffness is independently associated with a rapid decline in estimated glomerular filtration rate in patients with type 2 diabetes.
BACKGROUND
Diabetes and its vascular complications are main noncommunicable chronic diseases and major global health issues. Peripheral arterial disease (PAD) is highly prevalent in diabetes with nephropathy. We evaluated the associations of variables of arterial stiffness and the decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes.


METHODS
A total of 577 type 2 diabetic patients (mean ± SD: age, 63 ± 11 years) were enrolled. A rapid decline in eGFR was defined as progressively lower eGFR detected at both the 6- and 12-month follow-up visits, plus a reduction in eGFR more than 3 mL · min(-1)per 1.73 m(2) per year.


RESULTS
Higher glycated hemoglobin (HbA1c), systolic blood pressure (SBP), pulse pressure (PP), and brachial-ankle pulse wave velocity (ba-PWV) at baseline were independently associated with a rapid decline in eGFR. The adjusted odds ratios (95% confidence intervals) for a rapid decline in eGFR for ba-PWV, SBP, and PP were 1.072 (1.011-1.136), 1.014 (1.004-1.025), and 1.025 (1.008-1.041), respectively, after adjustment for gender, age, body mass index, smoking, HbA1c, and baseline eGFR in separated models.


CONCLUSIONS
Ba-PWV may serve as a simple and noninvasive predictor of rapid renal function progression in type 2 diabetic patients.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital, Department of Health, Executive Yuan, No. 199, Section 1, Sanmin Road, Taichung 402, Taiwan.
Yi-Jing
YJ
Sheen
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital, Department of Health, Executive Yuan, No. 199, Section 1, Sanmin Road, Taichung 402, Taiwan.
Jiann-Liang
JL
Lin
Institute of Biostatistics, China Medical University, No. 91 Hsueh-Shih Road, Taichung 404, Taiwan.
Tsai-Chung
TC
Li
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital, Department of Health, Executive Yuan, No. 199, Section 1, Sanmin Road, Taichung 402, Taiwan.
Cho-Tsan
CT
Bau
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Taichung 407, Taiwan ; School of Medicine, National Defense Medical Center, Taipei, Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Institute of Medical Technology, National Chung-Hsing University, Taichung, Taiwan.
Wayne Huey-Herng
WH
Sheu
D000368:Aged; D001783:Blood Flow Velocity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000150:complications / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors; D059289:Vascular Stiffness