title: Glucose-related arterial stiffness and carotid artery remodeling: a study in normal subjects and type 2 diabetes patients.
abstract: BACKGROUND
  Hyperglycemia is associated with a higher carotid intima-media thickness (IMT); however, it is not established whether this increase reflects early atherosclerotic changes or adaptive remodeling responding to hyperglycemia-induced alteration in mechanical properties of the arterial wall.
  
  
  OBJECTIVE
  The aims of this study were to compare carotid geometry and circumferential wall stress between patients with type 2 diabetes mellitus (T2DM) and healthy controls and to evaluate the associations between chronic glucose exposure and measures of arterial structure and function.
  
  
  METHODS
  This was a case-control and cross-sectional study within institutional practice.
  
  
  METHODS
  PARTICIPANTS included 133 T2DM patients free of cardiovascular complications and 133 healthy controls with normal glucose metabolism, matched for sex, age, and body mass index.
  
  
  METHODS
  Common carotid artery (CCA) IMT, luminal diameter, wave speed, and local pulse pressure (PP) were evaluated.
  
  
  RESULTS
  As compared with controls, T2DM patients had higher (P < .0001) CCA IMT (640 ± 81 vs 709 ± 118 μm), luminal diameter (6.12 ± 0.67 vs 6.69 ± 0.56 mm), and brachial PP (47 ± 7 vs 57 ± 12 mm Hg), whereas luminal radius to IMT ratio (4.8 ± 0.7 vs 4.8 ± 0.8, P = .57) and circumferential wall stress (49.0 ± 8.3 vs 50.6 ± 10.3 kPa, P = .26) were comparable between the 2 groups. In T2DM patients, glycosylated hemoglobin was independently related to CCA wave speed and local PP, but not to IMT that was determined by age, local PP, and luminal diameter.
  
  
  CONCLUSIONS
  This study suggests that the increase in IMT associated with a higher glucose exposure might reflect adaptive remodeling counteracting an increase in pulsatile strain and preventing increase in circumferential wall stress caused by luminal enlargement of stiff arteries.
authors: Departments of Clinical and Experimental Medicine (M.K., C.M., C.B., M.D.F., R.M.) and Surgical, Medical, Molecular Pathology and Critical Care (V.D.B., C.P.), University of Pisa, 56126 Pisa, Italy; and Institute of Clinical Physiology (M.P.), Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy.
authors: Michaela
authors: M
authors: Kozakova
authors: Carmela
authors: C
authors: Morizzo
authors: Cristina
authors: C
authors: Bianchi
authors: Marianna
authors: M
authors: Di Filippi
authors: Roberto
authors: R
authors: Miccoli
authors: Marco
authors: M
authors: Paterni
authors: Vitantonio
authors: V
authors: Di Bello
authors: Carlo
authors: C
authors: Palombo
mesh_terms: D001786:Blood Glucose; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D001786:Blood Glucose