title: The systolic-diastolic difference in carotid stiffness is increased in type 2 diabetes: The Maastricht Study.
abstract: In type 2 diabetes (T2D), increased arterial stiffening results from accelerated arterial wall matrix remodeling. The associated structural alterations modify the pressure dependency of arterial stiffness, which can be quantified by the systolic-diastolic difference in carotid pulse wave velocity (δPWV). We evaluated the association between T2D and δPWV as marker for matrix remodeling and whether δPWV may contain additional information beyond carotid stiffness (cPWV).
  
  
  
  In 746 individuals from The Maastricht Study, 415 with normal glucose metabolism; 126 with prediabetes; and 205 with T2D, carotid pulse wave velocity (cPWV) and δPWV were determined by ultrasonography and tonometry. Multiple linear regression analyses were used to investigate associations of glucose metabolism status (with normal glucose metabolism as reference) with cPWV and δPWV, adjusting for age, sex, mean arterial pressure, prior cardiovascular disease, estimated glomerular filtration rate and smoking, and δPWV or cPWV as appropriate.
  
  
  
  After adjustment for age, sex, mean arterial pressure, prior cardiovascular disease, estimated glomerular filtration rate and smoking, T2D was associated with greater cPWV [β (95% confidence interval) 0.376 (0.119; 0.632)] and δPWV [0.301 (0.013; 0.589)]. After additional adjustment for δPWV or cPWV, associations of T2D with cPWV and δPWV were attenuated [0.294 (0.048; 0.539) and 0.173 (-0.103; 0.449), respectively]. Prediabetes was not associated with either cPWV or δPWV.
  
  
  
  The systolic-diastolic difference in carotid stiffness is increased in T2D, but not prediabetes. Importantly, the association was not abolished by carotid stiffness, which suggests that systolic-diastolic difference in carotid stiffness carries additional information regarding arterial matrix remodeling.
authors.affiliation: aDepartment of Internal Medicine, Maastricht University Medical Centre +bCARIM School for Cardiovascular Diseases, Maastricht UniversitycHeart and Vascular CentredDepartment of RadiologyeDepartment of Cardiology, Maastricht University Medical Centre +fCAPHRI School for Public Health and Primary CaregDepartment of Epidemiology, Maastricht UniversityhDepartment of Biomedical Engineering, Maastricht University Medical Centre +, Maastricht, The Netherlands.
authors.forename: Marja G J
authors.initials: MG
authors.lastname: Veugen
authors.forename: Ronald M A
authors.initials: RM
authors.lastname: Henry
authors.forename: Thomas T
authors.initials: TT
authors.lastname: van Sloten
authors.forename: Evelien
authors.initials: E
authors.lastname: Hermeling
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Brunner-La Rocca
authors.forename: Miranda T
authors.initials: MT
authors.lastname: Schram
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.forename: Casper G
authors.initials: CG
authors.lastname: Schalkwijk
authors.forename: Abraham A
authors.initials: AA
authors.lastname: Kroon
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Koen D
authors.initials: KD
authors.lastname: Reesink
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003971:Diastole; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011236:Prediabetic State / Q000503:physiopathology*; D063177:Pulse Wave Analysis; D013599:Systole; D014463:Ultrasonography; D059289:Vascular Stiffness
chemical_list: D001786:Blood Glucose