Key result
In patients with type 2 diabetes, a carotid-femoral pulse wave velocity cut-off of 7.9 m/s was identified as an indicator of arterial stiffness (AUC 0.932, sensitivity 90%, specificity 80%).
Why the study?
The clinical discriminative value and determinants of arterial stiffness in individuals with type 2 diabetes mellitus were not well defined.
What is the discriminative cut-off value and what are the clinical determinants of arterial stiffness measured by cfPWV in patients with type 2 diabetes?
Cross-Sectional (n=51)
No
What is the discriminative cut-off value and what are the clinical determinants of arterial stiffness measured by cfPWV in patients with type 2 diabetes?
Effect estimate: AUC 0.932
p-value: p=<0.001
A cfPWV cut-off of 7.9 m/s may serve as a useful indicator of arterial stiffness in patients with type 2 diabetes, with poor glycemic control, hypertension, and dyslipidemia acting as key determinants.
May inform arterial stiffness assessment in type 2 diabetes; leaves open routine adoption without prospective validation.
OBJECTIVES: To identify the clinical discriminative value and determinants of arterial stiffness in individuals with type 2 diabetes mellitus (T2DM). METHODS: This prospective cohort study included 51 individuals (53.57±9.35 years) diagnosed with T2DM (stage glucose≥126 mg/dL; diagnostic time: 87.4±69.8 months). All participants underwent an initial evaluation of personal habits, medications, and history; arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor; and blood laboratory analysis. A statistical analysis was performed using SPSS software, and values of p≤0.05 were considered significant. RESULTS: A cut-off cfPWV value of 7.9 m/s was identified for T2DM [Sensitivity (SE): 90% and Specificity (SP): 80%]. A subgroup analysis revealed higher glycated hemoglobin (Hb1Ac) (p=0.006), obesity (p=0.036), and dyslipidemia (p=0.013) than those with cfPWV ≥7.9 m/s. Multivariate analysis identified higher stage glucose (p=0.04), Hb1Ac (p=0.04), hypertension (p=0.001), and dyslipidemia (p=0.01) as determinant factors of cfPWV; positive and significant correlation between cfPWV and glucose (r=0.62; p=0.0003) and Hb1Ac (r=0.55; p=0.0031). CONCLUSIONS: In T2DM, an indicator of the discriminative value of arterial stiffness was cfPWV of 7.9 m/s. Clinical findings and comorbidities, such as hypertension, glucose, poor glycemic control, and dyslipidemia, were associated with and were determinants of arterial stiffness in T2DM. Reinforcement of monitoring risk factors, such as hypertension, dyslipidemia, and glycemic control, seems to be essential to the process of arterial stiffening. Confirmation of this discriminative value in larger populations is recommended.
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Monteiro et al. (2021) conducted a cross-sectional in Type 2 diabetes mellitus (n=51). Clinical and metabolic risk factors was evaluated on Discriminative value of carotid-femoral pulse wave velocity (cfPWV) for arterial stiffness (AUC 0.932, p=<0.001). In patients with type 2 diabetes, a carotid-femoral pulse wave velocity cut-off of 7.9 m/s was identified as an indicator of arterial stiffness (AUC 0.932, sensitivity 90%, specificity 80%).
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