title: Arterial stiffness in diabetes mellitus.
abstract: Arterial stiffness is an age-related process that is a shared consequence of numerous diseases including diabetes mellitus (DM), and is an independent predictor of mortality both in this population and in the general population. While much has been published about arterial stiffness in patients with DM, a thorough review of the current literature is lacking. Using a systematic literature search strategy, we aimed to summarize our current understanding related to arterial stiffness in DM. We review key studies demonstrating that, among patients with established DM, arterial stiffness is closely related to the progression of complications of DM, including nephropathy, retinopathy, and neuropathy. It is also becoming clear that arterial stiffness can be increased even in pre-diabetic populations with impaired glucose tolerance, and in those with the metabolic syndrome (METS), well before the onset of overt DM. Some data suggests that arterial stiffness can predict the onset of DM. However, future work is needed to further clarify whether large artery stiffness and the pulsatile hemodynamic changes that accompany it are involved in the pathogenesis of DM, and whether interventions targeting arterial stiffness are associated with improved clinical outcomes in DM. We also review of the potential mechanisms of arterial stiffness in DM, with particular emphasis on the role of advanced glycation endproducts (AGEs) and nitric oxide dysregulation, and address potential future directions for research.
authors.affiliation: University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, 6 Penn Tower, Philadelphia, PA 19104, USA.
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Prenner
authors.affiliation: University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, 6 Penn Tower, Philadelphia, PA 19104, USA; Philadelphia VA Medical Center, Division of Cardiology - Suite 8B111, University & Woodland Avenues, Philadelphia, PA 19104, USA. Electronic address: julio.chirinos@uphs.upenn.edu.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Chirinos
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018450:Disease Progression; D017127:Glycation End Products, Advanced / Q000097:blood; D006801:Humans; D009569:Nitric Oxide / Q000097:blood; D011379:Prognosis; D012307:Risk Factors; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D017127:Glycation End Products, Advanced; D009569:Nitric Oxide
keywords: Arterial stiffness; Diabetes mellitus