title: The Impact of Diabetes Mellitus on Vascular Biomarkers in Patients with End-Stage Renal Disease.
abstract: OBJECTIVE
  Diabetes mellitus (DM) is the most common cause of end-stage renal disease (ESRD) and an important risk factor for cardiovascular (CV) disease. We investigated the impact of DM on subclinical CV damage by comprehensive screening protocol in ESRD patients.
  
  
  METHODS
  Echocardiography, coronary computed tomography angiogram, 24-h ambulatory blood pressure monitoring, and central blood pressure with pulse wave velocity (PWV) were performed in 91 ESRD patients from the Cardiovascular and Metabolic disease Etiology Research Center-HIgh risk cohort.
  
  
  RESULTS
  The DM group (n=38) had higher systolic blood pressure than the non-DM group (n=53), however, other clinical CV risk factors were not different between two groups. Central aortic systolic pressure (148.7±29.8 mm Hg vs. 133.7±27.0 mm Hg, p= 0.014), PWV (12.1±2.7 m/s vs. 9.4±2.1 m/s, p<0.001), and early mitral inflow to early mitral annulus velocity (16.7±6.4 vs. 13.7±5.9, p=0.026) were higher in the DM group. Although the prevalence of coronary artery disease (CAD) was not different between the DM and the non-DM group (95% vs. 84.4%, p=0.471), the severity of CAD was higher in the DM group (p=0.01). In multivariate regression analysis, DM was an independent determinant for central systolic pressure (p=0.011), PWV (p<0.001) and the prevalence of CAD (p=0.046).
  
  
  CONCLUSIONS
  Diabetic ESRD patients have higher central systolic pressure and more advanced arteriosclerosis than the non-DM control group. These findings suggest that screening for subclinical CV damage may be helpful for diabetic ESRD patients.
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Jeonggeun
authors.initials: J
authors.lastname: Moon
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chan Joo
authors.initials: CJ
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Hak
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seok Min
authors.initials: SM
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. yoosy0316@yuhs.ac.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Yoo
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. shpark0530@yuhs.ac.
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
mesh_terms: D000368:Aged; D001011:Aorta; D015415:Biomarkers; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012044:Regression Analysis; D012307:Risk Factors; D013599:Systole / Q000502:physiology
chemical_list: D015415:Biomarkers
keywords: End-stage renal disease; coronary artery disease; diabetes mellitus; hypertension; target organ damage