title: Prediabetes and Diabetes Are Associated With Arterial Stiffness in Older Adults: The ARIC Study.
abstract: To determine whether prediabetes and diabetes in older adults are associated with arterial stiffness measured in central and peripheral arteries and to examine characteristics that modify these associations.
  
  
  
  Cohort members attending the 5th exam (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) study had pulse wave velocity (PWV) measures performed at the carotid-femoral (cfPWV), brachial-ankle (baPWV), and femoral-ankle (faPWV) segments. Fasting glucose ≥126mg/dl, glycated hemoglobin (HbA1c) ≥6.5%, or currently taking diabetes medication defined diabetes. Fasting glucose 100-125mg/dl or HbA1c 5.7%-6.4% among those without diabetes defined prediabetes. Cross-sectional associations were modeled using multivariable linear regression.
  
  
  
  Among 4,279 eligible participants with cfPWV measures (mean age 75 years), 22% were African-American, 25.5% had diabetes, and 54.7% had prediabetes. Compared to those with normal glucose, cfPWV was 95.8cm/s higher (stiffer) on average for those with diabetes (for reference: being 1 year older was associated with 14.4cm/s higher cfPWV). Similar findings were seen for diabetes and baPWV, although attenuated. Interestingly, faPWV was 17.6cm/s lower for those with diabetes compared to normal glucose. There was a significant positive association between baPWV and prediabetes. Among those with diabetes, cfPWV was higher for those with albuminuria, reduced kidney function, duration of diabetes ≥10 years, and elevated HbA1c (HbA1c ≥7).
  
  
  
  Among older adults, diabetes is associated with higher central arterial stiffness and lower peripheral arterial stiffness, and prediabetes is associated with higher baPWV. Cross-sectionally, the magnitude of the effect of diabetes on central stiffness is equivalent to 6 years of arterial aging.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; lloehr@email.unc.edu.
authors.forename: Laura R
authors.initials: LR
authors.lastname: Loehr
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Meyer
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Anna K
authors.initials: AK
authors.lastname: Poon
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA;
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Priya
authors.initials: P
authors.lastname: Palta
authors.affiliation: University of Texas at Austin, Austin, Texas, USA;
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: University of Minnesota, Minneapolis, Minnesota, USA;
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.affiliation: National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA;
authors.forename: Jacqueline D
authors.initials: JD
authors.lastname: Wright
authors.affiliation: University of Mississippi Medical Center, Jackson, Mississippi, USA;
authors.forename: Michael E
authors.initials: ME
authors.lastname: Griswold
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Wagenknecht
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011236:Prediabetic State / Q000503:physiopathology*; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness
keywords: arterial stiffness; blood pressure; diabetes; hypertension; peripheral arterial stiffness; prediabetes; pulse wave velocity; race.