Determinants of 1-Year Changes of Brachial Ankle Pulse Wave Velocity (baPWV) in Patients with Type 2 Diabetes Mellitus

Kyung Won Yun; Bo Hyun Kim; Young Pil Bae; Byeong Do Yi; Seung Woo Lee; Hong Kyu Lim; Yeon Sik Ryu; Chang Won Lee

doi:10.4093/kdj.2008.32.4.346

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Yun, Kim, Bae, Yi, Lee, Lim, Ryu, and Lee: Determinants of 1-Year Changes of Brachial Ankle Pulse Wave Velocity (baPWV) in Patients with Type 2 Diabetes Mellitus

Original Article

Korean Diabetes Journal

Korean Diabetes Journal 2008; 32(4): 346-357.

Published online: 31 August 2008

DOI: https://doi.org/10.4093/kdj.2008.32.4.346

Determinants of 1-Year Changes of Brachial Ankle Pulse Wave Velocity (baPWV) in Patients with Type 2 Diabetes Mellitus

Kyung Won Yun, Bo Hyun Kim, Young Pil Bae, Byeong Do Yi, Seung Woo Lee, Hong Kyu Lim, Yeon Sik Ryu, Chang Won Lee

Department of Endocrinology and Metabolism, Busan St. Mary's Medical Center, Korea.

Received 9 January 2008 Accepted 7 July 2008

Abstract

Background

Cardiovascular disease is the leading cause of mortality in type 2 diabetes. PWV correlates well with arterial distensibility and stiffness and a useful approach for evaluating the severity of systemic atherosclerosis in adults, and, in particular, the measurement of brachial-ankle PWV (baPWV) has been commonly reported as a simple, noninvasive and practicable method. baPWV was mainly affected by age, SBP and sex. And also, baPWV was affected by many different factors such as body weight, BMI, waist to hip ratio, HbA1c, microalbuminuria, triglyceride, γGTP, duration of DM. We evaluated determinants of 1-year changes of baPWV in patients with type 2 DM.

Methods

The study group comprised 189 diabetic patients who measured ankle brachial pressure index (ABI), baPWV at base line and 1-year later. The anthropometric parameters, blood pressure, pulse pressure, fasting plasma glucose (FBS), fasting insulin, A1c, lipid profile, hsCRP, microalbuminuria, AST/ALT, γGTP were also checked concurrently. We also analyzed correlation between change of baPWV and subject's medications. We retrospectively analyzed the relationship between the 1-year changes of baPWV and the other factors. All analyses were performed with the SPSS Version 14.0 and P values < 0.05 were considered significant.

Results

baPWV change was affected by systolic blood pressure change, diastolic blood pressure change, pulse pressure change, body weight, BMI, triglyceride change, insulin treatment and total cholesterol. Multiple regression analysis of the relationship between change of baPWV and other associated variables shows that the 1-year change of baPWV was significantly associated with the changes of blood pressure and insulin treatment in patients with type 2 DM.

Conclusion

1-year change of baPWV was significantly associated with the changes of blood pressure in patients with type 2 DM.

Keywords: Ankle brachial pressure index, Brachial-ankle pulse-wave velocity, Diabetes, Systolic blood pressure

Figures and Tables

Fig. 1

Correlation between change of maximal baPWV and change of SBP. There was significant positive correlation between change of maxima baPWV and change of SBP (r = 0.636, P < 0.001).

Table 1

Baseline characteristics of the study subjects

Data are mean ± SD. P value < 0.05 were considered significant. BMI, body mass index; DM, diabetes mellitus; ABI, ankle brachial index; baPWV, brachial-ankle pulse wave velocity; Rt, right; Lt, left; HbA1c, hemoglobin A1c; LDL, low density lipoprotein; HDL, high density lipoprotein; HOMA-IR, homeostasis model assessment of insulin resistance; hsCRP, high sensitive C-reactive protein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; γGTP, gamma glutamyltransferase; PLT, platelet; ACE, angiotensin converting enzyme; CCB, calcium channel blocker; HTN, hypertension.

Table 2

Characteristics of the study subjects after 1 year

Data are mean ± SD. P value < 0.05 were considered significant. ABI, ankle brachial index; baPWV, brachial-ankle pulse wave velocity; Rt, right; Lt, left; HbA1c, hemoglobin A1c; LDL, low density lipoprotein; HDL, high density lipoprotein; HOMA-IR, homeostasis model assessment of insulin resistance; hsCRP, high sensitive C-reactive protein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; γGTP, gamma glutamyltransferase.

Table 3

Baseline and 1 year later characteristics of the study subjects

Data are mean ± SD. p value < 0.05 were considered significant. ABI, ankle brachial index; baPWV, brachial-ankle pulse wave velocity; Rt, right; Lt, left; HbA1c, hemoglobin A1c; LDL, low density lipoprotein; HDL, high density lipoprotein; HOMA-IR, homeostasis model assessment of insulin resistance; hsCRP, high sensitive C-reactive protein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; γGTP, gamma glutamyltransferase.

Table 4

Correlation between maximal baPWV difference and baseline characteristics

P value < 0.05 were considered significant. BMI, body mass index; DM, diabetes mellitus; PLT, platelet; ACE, angiotensin converting enzyme; CCB, calcium channel blocker; HTN, hypertension.

Table 5

Correlation between maximal baPWV difference and variable factor

P value < 0.05 were considered significant. SBP, Systolic blood pressure; DBP, Diastolic blood pressure; ABI, ankle brachial index; baPWV, brachial-ankle pulse wave velocity; Rt, right; Lt, left; HbA1c, hemoglobin A1c; LDL, low density lipoprotein; HDL, high density lipoprotein; HOMA-IR, homeostasis model assessment of insulin resistance; hsCRP, high sensitive C-reactive protein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; γGTP, gamma glutamyltransferase.

Table 6

Correlation between maximal baPWV difference and baseline characteristics in the baPWV improving group and worsening group

P value < 0.05 were considered significant. BMI, body mass index; DM, diabetes mellitus; PLT, platelet; ACE, angiotensin converting enzyme; CCB, calcium channel blocker; HTN, hypertension.

Table 7

Correlation between maximal baPWV difference and variable factors in the baPWV improving group and worsening group

Table 8

Multiple regression analysis of the relationship between change of maximal baPWV and other associated variables.

P value < 0.05 were considered significant. BMI, body mass index; SBP, Systolic blood pressure.

Table 9

Multiple regression analysis of the relationship between change of maximal baPWV and other associated variables.

P value < 0.05 were considered significant. BMI, body mass index; DBP, Diastolic blood pressure.

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