title: Clinical Significance of Arterial Stiffness and Thickness Biomarkers in Type 2 Diabetes Mellitus: An Up-To-Date Meta-Analysis.
abstract: BACKGROUND
  Type 2 Diabetes mellitus (T2DM) is associated with increased risk of cardiovascular disease (CVD). Previous studies explored the association of T2DM with arterial stiffness and thickness biomarkers including the augmentation index (AIX), aortic pulse wave velocity (aPWV), brachial-ankle PWV (baPWV), carotid intima-media wall thickness (IMT) as well as blood pressure (BP), low density lipoprotein cholesterol (LDL-C); however the conclusions are either inconsistent or incomprehensive.
  
  
  METHODS
  The average differences of each included trial were expressed as the standardized mean difference (SMD) with 95% confidence interval (CI). Analyses of carotid IMT, aPWV, baPWV and AIX Systolic BP (SBP), diastolic BP (DBP), LDL-C and HDL-C were independently performed. Furthermore, subgroup analyses by ethnicity (Caucasian or Asian) were conducted. Begg's and Egger's tests were performed for potential publication biases detection.
  
  
  RESULTS
  A total of 14 case-control eligible studies with 1222 T2DM patients and 1094 control subjects were included. In the overall analysis, significant associations were observed between the carotid IMT, aPWV, baPWV, LDL-C, HDL-C, SBP, and DBP with T2DM (IMT: p=1.1*10-12; aPWV: p=1.1*10-7; baPWV: p=1.8*10-33; LDL-C: p=3.1*10-8; HDL-C: p=6.1*10-18; SBP: p=3.9*10-21; DBP: p=4.8*10-5). No association was detected for AIX (p=0.09). Subgroup analyses indicated that aPWV, baPWV, SBP, LDL-C, and HDL-C were associated with T2DM in both white and Asian populations (p<0.05). The significant associations of IMT, AIX and DBP with T2DM were only observed in the Asian subgroup.
  
  
  CONCLUSIONS
  Carotid IMT, aPWV, baPWV, as well as LDL-C, HDL-C, SBP, and DBP but not AIX were useful noninvasive early markers for T2DM vascular dysfunction detection.
authors: Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).
authors: Yang
authors: Y
authors: Yapei
authors: Oral Maxillofacial Head-Neck Key Laboratory of Medical Biology, and Central Laboratory of Liaocheng People's Hospital, Liaocheng, Shandong, China (mainland).
authors: Ren
authors: R
authors: Xiaoyan
authors: Oral Maxillofacial Head-Neck Key Laboratory of Medical Biology, and Central Laboratory of Liaocheng People's Hospital, Liaocheng, Shandong, China (mainland).
authors: Zeng
authors: Z
authors: Sha
authors: Oral Maxillofacial Head-Neck Key Laboratory of Medical Biology, and Central Laboratory of Liaocheng People's Hospital, Liaocheng, Shandong, China (mainland).
authors: Pan
authors: P
authors: Li
authors: The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, Shandong, China (mainland).
authors: Meng
authors: M
authors: Xiao
authors: Oral Maxillofacial Head-Neck Key Laboratory of Medical Biology, and Central Laboratory of Liaocheng People's Hospital, Liaocheng, Shandong, China (mainland).
authors: Chen
authors: C
authors: Shuangfeng
authors: Oral Maxillofacial Head-Neck Key Laboratory of Medical Biology, and Central Laboratory of Liaocheng People's Hospital, Liaocheng, Liaocheng, Shandong, China (mainland).
authors: Wang
authors: W
authors: Lexin
authors: Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).
authors: Cui
authors: C
authors: Lianqun
mesh_terms: D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D063177:Pulse Wave Analysis; D012307:Risk Factors; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL