title: Association Between Arterial Stiffness and Skin Microvascular Function: The SUVIMAX2 Study and The Maastricht Study.
abstract: BACKGROUND
  It has been hypothesized that arterial stiffness leads to generalized microvascular dysfunction and that individuals with type 2 diabetes mellitus (T2DM) are particularly prone to the detrimental effects of arterial stiffness. However, evidence for an association between stiffness and markers of generalized microvascular dysfunction is lacking. We therefore investigated the association between arterial stiffness and skin microvascular function in individuals without and with T2DM.
  
  
  METHODS
  Cross-sectional data were used of The Supplementation en Vitamines et Mineraux Antioxydants 2 (SUVIMAX2) Study (n = 284/62.2 years/48.6% women/0% T2DM (by design)) and The Maastricht Study (n = 737/59.7 years/45.2% women/28.8% T2DM (by design)). Arterial stiffness was determined by carotid-femoral pulse wave velocity (cfPWV). Skin capillaroscopy was used to determine capillary density at baseline, and during reactive hyperemia and venous congestion. Laser Doppler flowmetry was used to assess acetylcholine- and local heating-induced vasoreactivity, and skin flowmotion.
  
  
  RESULTS
  In The SUVIMAX2 Study, cfPWV (per +1 SD) was not associated with baseline capillary density (regression coefficient: -0.48 (95% confidence interval: 2.37; 1.41)) or capillary recruitment during venous congestion (0.54% (-0.74; 1.81%)). In addition, cfPWV was not associated with acetylcholine (-0.02% (-0.14; 0.10%)) or local heating-induced vasoreactivity (0.03% (-0.07; 0.12%)). In The Maastricht Study, in individuals without T2DM, cfPWV was not associated with baseline capillary density (-1.20 (-3.17; 0.77)), and capillary recruitment during reactive hyperemia (1.22% (-0.41; 2.84%)) or venous congestion (1.50% (-0.25; 3.25%)). In addition, cfPWV was not associated with flowmotion (-0.01 (-0.07; 0.06)). Results were adjusted for age and sex. Additional adjustments for confounders did not materially change these results. Results were qualitatively similar in individuals with T2DM.
  
  
  CONCLUSIONS
  Arterial stiffness is not associated with skin microvascular function, irrespective of the presence of T2DM.
authors.forename: Thomas T
authors.initials: TT
authors.lastname: van Sloten
authors.forename: Sébastien
authors.initials: S
authors.lastname: Czernichow
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Alfons J
authors.initials: AJ
authors.lastname: Houben
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Athanase D
authors.initials: AD
authors.lastname: Protogerou
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Henry
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Muris
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Miranda T
authors.initials: MT
authors.lastname: Schram
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Simone J
authors.initials: SJ
authors.lastname: Sep
authors.affiliation: Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands; School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Epidemiology, Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Carla J
authors.initials: CJ
authors.lastname: van der Kallen
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands; School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands;
authors.forename: Nicolaas C
authors.initials: NC
authors.lastname: Schaper
authors.affiliation: Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, AP-HP, Paris Descartes University, Paris, France;
authors.forename: Jacques
authors.initials: J
authors.lastname: Blacher
authors.affiliation: Nutritional Epidemiology Research Group, Sorbonne-Paris-Cité, UMR University of Paris 13/INSERM U557/INRA U1125/CNAM, Bobigny, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.affiliation: INSERM, UMS 011 Population-based cohorts, Villejuif, France;
authors.forename: Bernard I
authors.initials: BI
authors.lastname: Levy
authors.affiliation: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands; cda.stehouwer@mumc.nl.
authors.forename: Coen D
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005602:France; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D020678:Microscopic Angioscopy; D055806:Microvessels / Q000187:drug effects / Q000503:physiopathology*; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*; D012881:Skin Temperature; D059289:Vascular Stiffness; D014664:Vasodilation; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D000109:Acetylcholine
keywords: blood pressure; epidemiology; hypertension; microcirculation; type 2 diabetes mellitus; vascular stiffness.