Arterial Stiffness and HbA1c: Association Mediated by Insulin Resistance in Hispanic Adults

Figures

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  Figure A1. (A) Level and distribution of missingness for each variable, with visceral adipose tissue (VAT) having the most missing values. (B) Distribution of imputed values (red) after multiple imputations with the mice R package for selected imputed variables.

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  Figure A2. Linear correlation matrix between cardiovascular (PWV, AIX75, Buckberg, SEVR, MAP, and HR) and metabolic parameters. Non-significant correlations are crossed out. Variables were standardized and normalized using the ordered quantile (ORQ) normalization of the BestNormalize R package.

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  Figure A3. Relationship between fasting plasma glucose and different vascular health parameters; PWV (A), AIX75 (B), and Buckberg SEVR (C). The best polynomic adjustment was assessed with BIC minimization. These findings are identical to those observed when using HbA1c instead of FPG. Variables were standardized and normalized using the ordered quantile (ORQ) normalization of the BestNormalize R package. Abbreviations: AIX75: Heart-rate-corrected augmentation index. BIC: Bayesian information criterion. FPG: Fasting plasma glucose. PWV: Pulse-wave velocity. SEVR: Subendocardial viability ratio.

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  Figure A4. Interaction analysis to investigate the factors that modify the relationship between HbA1c and PWV. This relationship is not affected by age ≥ 50 (A), BMI ≥ 30 kg/m2 (B), insulin resistance using METS-IR as a clinical surrogate (C), triglycerides ≥ 150 mg/dL (D), total cholesterol ≥ 200 mg/dL (E), or cholesterol remnants ≥ 30 mg/dL (F). Variables were standardized and normalized using the ordered quantile (ORQ) normalization of the BestNormalize R package.

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  Figure 1. Study population flow-chart.

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  Figure 2. (A–C) Diabetes status has a positive association with PWV and AIX75 and a negative association with Buckberg SEVR. (D–F) According to BIC minimization, the best relationships of HbA1c are cubic for PWV, quadratic for AIX75, and linear for Buckberg SEVR. Given that the cubic relationship between HbA1c and PWV declined after adjusting for covariates, we present the regression analysis for PWV as a linear relationship. Abbreviations: PWV: Pulse-wave velocity. AIX75: Heart-rate-corrected augmentation index at 75 bpm. SEVR: Subendocardial viability ratio. BIC: Bayesian information criterion.

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  Figure 3. (A–F) show the interactions of sex, FGP, blood pressure, VAT, LDL-C, and non-HDL-C with HbA1c and PWV, respectively. The linear relationship between HbA1c and PWV is modified by sex, FGP ≥ 126 mg/dL, hypertension (SBP ≥ 140 mg/dL or DBP ≥ 90 mg/dL), visceral obesity (VAT ≥ 1 kg), LDL-C ≥ 100 mg/dL, and non-HDL-C ≥ 130 mg/dL. Abbreviations: HbA1c: Glycated hemoglobin. PWV: Pulse-wave velocity. FGP: fasting glucose plasma. VAT: Visceral adipose tissue. DBP: Diastolic blood pressure. SBP: Systolic blood pressure. HDL-C: High-density lipoprotein cholesterol. LDL-C: Low-density lipoprotein cholesterol.