☆ 4.7 Article

Carotid-Femoral Pulse Wave Velocity Is Associated With Cerebral White Matter Lesions in Type 2 Diabetes

DIABETES CARE (2013)

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DIABETES CARE

卷 36, 期 3, 页码 722-728

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AMER DIABETES ASSOC

DOI: 10.2337/dc12-0942

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Endocrinology & Metabolism

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Novo Nordisk Foundation
A.P. Moller Foundation for the Advancement of Medical Science
Beckett Foundation
Aase and Ejnar Danielsen Foundation
Novo Nordisk Fonden [NNF13OC0003820] Funding Source: researchfish

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摘要

OBJECTIVE-Patients with type 2 diabetes have a high incidence of cardiovascular events including stroke. Increased arterial stiffness (AS) predicts cardiovascular events in the general population. Cerebral white matter lesions (WMLs) are associated with an increased risk of stroke. It is unknown whether AS in patients with type 2 diabetes is associated with WMLs. RESEARCH DESIGN AND METHODS-We examined 89 patients recently diagnosed with type 2 diabetes (<5 years) and 89 sex- and age-matched controls. AS was assessed with carotid-femoral pulse wave velocity (PWV). WMLs were identified using magnetic resonance imaging and graded qualitatively with the Breteler scale (no/slight changes = 0, moderate changes = 1, severe changes = 2) and semiquantitatively. RESULTS-The diabetic population had excellent glycemic control (HbA(1c), 6.5% [6.2-6.8]; median [interquartile range {IQR}]) and had, compared with the controls, lower office blood pressure (BP) (127 +/- 12/79 +/- 8 vs. 132 +/- 14/84 +/- 10 mmHg) and total cholesterol (4.3 [3.9- 4.71vs. 5.6 [5.1-6.4]; mmol/L; median {IQR]), (P < 0.01 for all). Despite this, PWV was higher in the patients with diabetes compared with controls (9.3 +/- 2.0 vs. 8.0 +/- 1.6 m/s; P < 0.0001). PWV was associated with Breteler score (OR 1.36 [95% CI 1.17-1.581; P < 0.001) and WML volume (OR 1.32 [95% CI 1.16-1.511; P < 0.001) per 1 m/s increase in PWV. These associations remained significant when adjusted for age, sex, diabetes, 24-h mean arterial BP, BMI, heart rate, and use of antihypertensives and statins (Breteler score: OR 1.28 [95% Cl 1.03-1.601; P < 0.05 and WML volume: OR 1.30 [95% Cl 1.06-1.58]; P <005). CONCLUSIONS-PWV was higher among patients with well-controlled type 2 diabetes compared with controls and was independently associated with WMLs. PWV may represent a clinically relevant parameter in the evaluation of cerebrovascular disease risk in type 2 diabetes. Diabetes Care 36:722-728, 2013

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Comparison of carotid-femoral and brachial-ankle pulse wave velocity in association with carotid plaque in a Chinese community-based population

Bo Liu, Lan Gao, Bo Zheng, Ying Yang, Jia Jia, Pengfei Sun, Yimeng Jiang, Kaiyin Li, Jiahui Liu, Chuyun Chen, Jianping Li, Fangfang Fan, Yan Zhang, Yong Huo

Summary: This study evaluated and compared the relationships between pulse wave velocity (PWV) and carotid plaque, finding that both carotid-femoral PWV (cfPWV) and brachial-ankle PWV (baPWV) were independently associated with carotid plaque. Furthermore, cfPWV was more strongly correlated with carotid plaque than baPWV in participants with baseline baPWV >= 16.85 m/s.

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