Clinical interaction between diabetes duration and aortic stiffness in type 2 diabetes mellitus.
Diabetes complications increase with disease duration. No study was performed on the relationship between aortic stiffness and diabetes duration, taking into account the respective influence of such factors on macro- and microcirculation. In total, 618 subjects with type 2 diabetes (259 men) attending the Department of Internal Medicine of Tizi Ouzou Hospital (Algeria) were studied in collaboration with Hotel-Dieu Hospital (Paris, France). Brachial blood pressure (BP), anthropometric, clinical and biological data were evaluated. Aortic stiffness was estimated by carotid-femoral pulse wave velocity (PWV). From lower to higher tertile of diabetes duration, age, BP and PWV (10.1±2.7 to 12.3±2.8 m s-1) increased, while diabetes control and renal function worsened (all P<0.01). Diabetes duration was independently associated with PWV (R2=0.035, P<0.0001), even after adjustment for age, BP, heart rate, cardiovascular events and metabolic syndrome. Diabetes duration was significantly correlated to the prevalence of microalbuminuria (OR (95% CL) 1.3 (1.06-1.63), P=0.01), independently of age, sex, BP and renal function. Increased aortic stiffness was independently associated with the prevalence of cardiovascular events (P<0.001), reaching its maximal value above the first 2 years of diabetes duration. In conclusion, diabetes duration is an independent determinant of aortic stiffness in subjects with type 2 diabetes, representing about 4% of PWV variability. Diabetes duration is associated with microvascular complications independently of renal function, and with macrovascular complications through the presence of increased aortic stiffness.
Department of Internal Medicine, Sacro Cuore Hospital, Verona, Italy.|Paris Descartes University, Hôtel-Dieu Hospital, Paris, France.
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0000-0001-8108-7133
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Agnoletti
Department of Internal Medicine of Tizi Ouzou Hospital, Tizi Ouzou, Algeria.
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AS
Mansour
Department of Cardiology Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
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Y
Zhang
Hypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Medicine, 'Laiko' Hospital Medical School National and Kapodistrian University of Athens, Athens, Greece.|Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
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Protogerou
Department of Internal Medicine of Tizi Ouzou Hospital, Tizi Ouzou, Algeria.
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S
Ouerdane
Paris Descartes University, Hôtel-Dieu Hospital, Paris, France.
J
J
Blacher
Paris Descartes University, Hôtel-Dieu Hospital, Paris, France.
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ME
Safar
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications; D002318:Cardiovascular Diseases / Q000209:etiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness