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Abstract
Background
Brachial ankle pulse wave velocity (BaPWV) and cardio ankle vascular index (CAVI), as indicators of arterial stiffness, are increased in type 2 diabetes. Albuminuria, as a cardiovascular risk factor in type 2 diabetes, can cause endothelial dysfunction and atherosclerosis, and these can increase arterial stiffness. So we investigated the hypothesis that increased albuminuria reflects increased BaPWV and CAVI in type 2 diabetes.
Methods
We retrospectively analyzed 106 patients (58 men and 48 women) with type 2 diabetes from March 2005 to September 2006. Urine albumin creatinine ratio (ACR) to evaluate urinary albumin excretion, BaPWV and CAVI were measured in all patients.
Results
All patients were divided 3 groups, normal group (ACR < 30 mg/g Cr., n = 31), microalbuminuria group(30 ≤ ACR ≤ 30 mg/g Cr., n = 42), proteinuria group(ACR > 300 mg/g Cr., n = 33). BaPWV and CAVI in microalbuminuria group and proteinuria group are faster than normal group. In bivariate correlation analysis, BaPWV was not associated with ACR, but CAVI was positively correlated to ACR (r = 0.285, P = 0.003). BaPWV was positively correlated to age, diabetes duration, body mass index, systolic blood pressure, diastolic pressure, pulse pressure and negatively correlated to glomerular filtration rate (GFR). CAVI was positively correlated to age, diabetes duration and negatively correlated to GFR. In multiple linear stepwise regression analysis, BaPWV was not associated with ACR, but ACR was independent predictor for CAVI (P = 0.002).
Figures and Tables
Table 1
Patients characteristics
BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; PP, pulse pressure; ACR, albumin creatinine ratio; HDL, high density lipoprotein; LDL, low density lipoprotein; FPG, fasting plasma glucose; HOMAIR, homeostatic model assessment insulin resistance; ABI, ankle brachial index; BaPWV, brachial ankle pulse wave velocity; CAVI, cardio ankle vascular index.
Table 2
Clinical characteristics divided into normal, microalbuminuria, and overt proteinuria group
*significantly higher than normal group, but not microalbuminuria group, P < 0.01; †significantly lower than normal group, but not microalbuminuria group,P < 0.05; ‡significantly higher than normal group,P < 0.05; §significantly higher than normal group and microalbuminuria group,P < 0.01; ∥significantly higher than normal group,P < 0.01.
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