Increased arterial stiffness is closely associated with hyperglycemia and improved by glycemic control in diabetic patients.
OBJECTIVE
Although arteriosclerotic diseases have been reported to be frequently complicated by diabetes mellitus (DM), a detailed relationship between hyperglycemia and arterial stiffness has not been fully clarified. We investigated the influence of hyperglycemia on arterial stiffness using the cardio-ankle vascular index (CAVI), which is a new method for estimating arterial stiffness.


METHODS
CAVI values of 52 early-staged DM patients (duration <5 years, no microangiopathies) were compared with those of 43 age-matched non-diabetic (NDM) subjects. The association between CAVI and clinical background factors was evaluated. The effect of glycemic improvement on CAVI was examined in 36 DM patients who were hospitalized for 2 weeks to treat hyperglycemia. CAVI and clinical parameters were measured twice during hospitalization and again after 8 weeks. Additionally, we measured CAVI before and 2 h after breakfast in five DM and five NDM subjects.


RESULTS
The CAVI of DM patients was significantly higher than that of NDM subjects. Multiple regression analysis showed that neither hypertension, obesity nor dyslipidemia, but aging and hemoglobin A1c (HbA1c) were significantly related to CAVI elevation. The CAVI, HbA1c and total cholesterol (TC) had significantly improved. Improvement of CAVI was significantly associated with HbA1c improvement. In contrast, no significant association was observed between the improvements of TC and CAVI. CAVI values before and after breakfast did not change significantly.


CONCLUSIONS
CAVI elevation seems to be a sensitive arteriosclerotic marker, which is closely associated with hyperglycemia and improved by glycemic control.
First Department of Medicine Wakayama Medical University Wakayama Japan.
Junko
J
Ibata
First Department of Medicine Wakayama Medical University Wakayama Japan.
Hideyuki
H
Sasaki
First Department of Medicine Wakayama Medical University Wakayama Japan.
Tadashi
T
Hanabusa
First Department of Medicine Wakayama Medical University Wakayama Japan.
Hisao
H
Wakasaki
First Department of Medicine Wakayama Medical University Wakayama Japan.
Hiroto
H
Furuta
First Department of Medicine Wakayama Medical University Wakayama Japan.
Masahiro
M
Nishi
First Department of Medicine Wakayama Medical University Wakayama Japan.
Takashi
T
Akamizu
First Department of Medicine Wakayama Medical University Wakayama Japan.
Kishio
K
Nanjo
Arterial stiffness; Cardio‐ankle vascular index; Glycemic control