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Arterial stiffness in type 2 diabetes: determinants and indication of a discriminative value

Authors
  • Monteiro, Clara Italiano1
  • Simões, Rodrigo Polaquini1, 2
  • Goulart, Cássia Luz1
  • da Silva, Claudio Donisete1
  • Borghi-Silva, Audrey1
  • Mendes, Renata Gonçalves1
  • 1 Laboratorio de Fisioterapia Cardiopulmunar (LACAP), Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, BR
  • 2 Programa de Pos-Graduacao em Ciencias da Reabilitacao, Universidade Federal de Alfenas, Alfenas, MG, BR
Type
Published Article
Journal
Clinics
Publisher
Faculdade de Medicina / USP
Publication Date
Feb 16, 2021
Volume
76
Identifiers
DOI: 10.6061/clinics/2021/e2172
PMID: 33624706
PMCID: PMC7885854
Source
PubMed Central
Keywords
License
Green

Abstract

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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