HbA1c is positively associated with pulse wave velocity and Flow-mediated dilation in the patients with type 2 diabetes

Objective To investigate the association between HbA1c status,arterial stiffness and endothelial function in subjects with type 2 diabetes mellitus(DM).Methods The study group consisted of 338 DM patients,including 74 subjects with normal HbA1c(≤ 6.0％)(Group A),102 subjects with mildly increased HbA1c(HbA1C increased by less than 6.5％)(Group B)and 162 patients with high HbA1c level (HbA1c increased by more than 6.5％)(Group C).All patients were evaluated for glucose,HbA1c,TC and TG.Pulse wave velocity(PWV)and flow-mediated dialation(FMD)were performed simultaneously.Results Compared with Group A,Group B and C had higher baPWV([1734 ± 343]cm/s vs.[1537 ± 313]cm/s and [1853 ± 364]cm/s vs.[1537 ± 313]cm/s).Patients in Group C had a higher baPWV than those in Group B ([1853 ± 364]cm/s vs.[1734 ± 343]cm/s,P =0.006).The patients in group A had a lower level of FMD than that of group B and C([4.20±3.13]％ vs[5.29±3.92]％,[4.09±2.79]％ vs.[5.29±3.92]％,P＜0.01).Leaner association analysis showed a positive correlation between baPWV and HbAlc(r =0.53,P ＜0.01).baPWV was negatively correlated with FMD(r =-0.25,P ＜0.01).Logistic regression analysis showed that HbA1c(OR32.19％,CI 11.26 ～53.12,P＜0.001),age(OR 14.21,95％ CI 11.43 ～ 17.00,P＜0.001),systolic blood pressure(OR 7.36,95％ CI 6.12-8.59)and TC(OR:0.31,95％ CI:9.97-70.64)were independent predictors for the increased arterial stiffness(baPWV).Conclusion Arterial stiffness parameters varied significantly across subgroups of patients with different levels of HbA1c and the arterial stiffness was positively associated with deranged glucose homeostasis.