title: Is visceral adiposity a modifier for the impact of blood pressure on arterial stiffness and albuminuria in patients with type 2 diabetes?
abstract: BACKGROUND
  We aimed to investigate whether visceral adiposity could modify the impact of blood pressure on arterial stiffness and albuminuria in patients with type 2 diabetes.
  
  
  METHODS
  This cross-sectional study examines the interaction of visceral adiposity with increased blood pressure on arterial stiffness and albuminuria. 638 patients with type 2 diabetes (mean age 64 ± 12 years; 40 % female) were enrolled. Visceral fat area (VFA, cm(2)) was assessed by a dual-impedance analyzer, whereby patients were divided into those with VFA < 100 (N = 341) and those with VFA ≥ 100 (N = 297). Albuminuria was measured in a single 24-h urine collection (UAE, mg/day) and brachial-ankle pulse wave velocity (ba-PWV, cm/s) was used for the assessment of arterial stiffening. Linear regression analyses were used to investigate the association of systolic blood pressure (SBP) and VFA with UAE and baPWV.
  
  
  RESULTS
  Patients with VFA ≥ 100 were significantly younger, had higher SBP, HbA1c, triglycerides, UAE, alanine aminotransferase, C-reactive protein and lower high-density lipoprotein and shorter duration of diabetes than those with VFA < 100. SBP was significantly and almost equivalently associated with ba-PWV both in VFA < 100 (standardized β 0.224, p = 0.001) and VFA ≥ 100 (standardized β 0.196, p = 0.004) patients in the multivariate regression analysis adjusting for covariates including age, gender, HbA1c, diabetic complications and the use of insulin and anti-hypertensive agents. By contrast, the association of SBP with UAE was stronger in patients with VFA ≥ 100 (standardized β 0.263, p = 0.001) than that in patients with VFA < 100 (standardized β 0.140, p = 0.080) in the multivariate regression model. In the whole cohort, the significant interaction between SBP and VFA on UAE (standardized β 0.172, p = 0.040) but not on ba-PWV (standardized β -0.008, p = 0.916) was observed.
  
  
  CONCLUSIONS
  The effect of increased blood pressure on arterial stiffness is almost similar in type 2 diabetic patients with both low and high visceral adiposity, while its association with albuminuria is stronger in the latter.
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. bouchi.mem@tmd.ac.jp.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Bouchi
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. oohara.mem@tmd.ac.jp.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ohara
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. asakawa.mem@tmd.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asakawa
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. nakano.mem@tmd.ac.jp.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Nakano
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. takeuchi.mem@tmd.ac.jp.
authors.forename: Takato
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. mmurakami.mem@tmd.ac.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Murakami
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. sasahara.mem@tmd.ac.jp.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Sasahara
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. numamem@tmd.ac.jp.
authors.forename: Mitsuyuki
authors.initials: M
authors.lastname: Numasawa
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. iminami.mem@tmd.ac.jp.
authors.forename: Isao
authors.initials: I
authors.lastname: Minami
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. hizumiyama.cme@tmd.ac.jp.|Center for Medical Welfare and Liaison Services, Tokyo Medical and Dental University, Tokyo, Japan. hizumiyama.cme@tmd.ac.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Izumiyama
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. khashimoto.mem@tmd.ac.jp.|Department of Preemptive Medicine and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. khashimoto.mem@tmd.ac.jp.
authors.forename: Koshi
authors.initials: K
authors.lastname: Hashimoto
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. tyoshimoto.mem@tmd.ac.jp.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Yoshimoto
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. ogawa.mem@tmd.ac.jp.|CREST, Japan Agency for Medical Research and Development, Tokyo, Japan. ogawa.mem@tmd.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ogawa
mesh_terms: D050154:Adiposity; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001794:Blood Pressure; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D017097:Electric Impedance; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016482:Urinalysis; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers