In patients with type 2 diabetes without overt renal impairment, raised albumin creatinine ratio (≥3 mg/mmol) was associated with higher aortic pulse wave velocity (P<0.05).
Cross-Sectional (n=134)
Is albuminuria associated with increased aortic pulse wave velocity in patients with type 2 diabetes without overt renal impairment?
In patients with type 2 diabetes without overt renal impairment, raised albuminuria is associated with higher aortic stiffness, likely mediated by elevated blood pressure.
p-value: p=<0.05
Development of microalbuminuria increases the risk for cardiovascular disease (CVD) in type 2 diabetes. The nature of this relationship is unclear but may involve arterial stiffness, an independent risk marker for CVD mortality. Aortic pulse wave velocity (Ao-PWV) and albumin creatinine ratio (ACR) were measured in 134 consecutive patients with type 2 diabetes without overt renal impairment (serum creatinine /=3 mg/mmol) had higher Ao-PWV, poorer diabetic control, and higher pulse pressure (PP) and systolic BP (SBP) (all P < 0.05) than those with normal ACR. The closest univariate associations of Ao-PWV were positively with age, duration of diabetes, SBP, PP, ACR, and insulin treatment and negatively with GFR and weight (all P < 0.01). In a multiple linear step-down regression analysis, the significant predictors of Ao-PWV were age, SBP or PP, duration of diabetes, gender, number of antihypertensive medications, and use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, which together explained 55% of the variance of Ao-PWV. When ACR was offered in place of arterial pressure to a separate model, ACR emerged as a significant predictor of Ao-PWV. After age adjustment, patients with lower, below median GFR had higher Ao-PWV than those with GFR above the median (P = 0.043). In patients with type 2 diabetes without overt renal impairment, raised ACR is associated with higher Ao-PWV, a relationship most likely mediated by raised BP. The association of Ao-PWV with reduced GFR suggests that even modest renal dysfunction may affect the viscoelastic properties of large arteries.
Smith et al. (Thu,) conducted a cross-sectional in Type 2 diabetes (n=134). Raised albumin creatinine ratio (≥3 mg/mmol) vs. Normal albumin creatinine ratio was evaluated on Aortic pulse wave velocity (Ao-PWV) (p=<0.05). In patients with type 2 diabetes without overt renal impairment, raised albumin creatinine ratio (≥3 mg/mmol) was associated with higher aortic pulse wave velocity (P<0.05).
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