Skip to main content
SpringerLink
Log in

Carotid stiffness and microalbuminuria in patients with type 2 diabetes

  • Original Paper
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Microalbuminuria is associated with higher cardiovascular mortality, especially in diabetics. But the direct association between microalbuminuria and vascular wall properties is still not clear. We investigated quantitative carotid stiffness (QCS) index in relation to microalbuminuria in 260 Chinese diabetic patients. In categorical analyses, patients with elevated urinary albumin-to-creatinine ratio (uACR) had higher QCS than those with normal uACR (P < 0.001). The corresponding values for QCS values were 4.4 and 5.9, respectively. In multiple stepwise regression analyses, QCS was significantly associated with age, uACR, plasma glycosylated hemoglobin A1C (HbA1C), and current smoking (P < 0.05 for all). In conclusion, carotid stiffness as measured by QCS, a local functional measurement of the arterial wall, is increased in type 2 diabetes with microalbuminuria.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. E. Bonora, S. Kiechl, F. Oberhollenzer, G. Egger, R.C. Bonadonna, M. Muggeo, J. Willeit, Impaired glucose tolerance, Type II diabetes mellitus and carotid atherosclerosis: prospective results from the Bruneck Study. Diabetologia 43, 156–164 (2000)

    Article  CAS  PubMed  Google Scholar 

  2. M. Wohlin, J. Sundström, J. Arnlöv, B. Andrén, B. Zethelius, L. Lind, Impaired insulin sensitivity is an independent predictor of common carotid intima-media thickness in a population sample of elderly men. Atherosclerosis 170, 181–185 (2003)

    Article  CAS  PubMed  Google Scholar 

  3. M. De Michele, S. Panico, E. Celentano, G. Covetti, M. Intrieri, F. Zarrilli, L. Sacchetti, R. Tang, M.G. Bond, P. Rubba, Association of impaired glucose homeostasis with preclinical carotid atherosclerosis in women: impact of the new American Diabetes Association Criteria. Metabolism 51, 52–56 (2002)

    Article  PubMed  Google Scholar 

  4. J. Stamler, O. Vaccaro, J.D. Neaton, D. Wentworth, Diabetes, other risk factors, and 12-year cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 16, 434–444 (1993)

    Article  CAS  PubMed  Google Scholar 

  5. C.E. Mogensen, E.M. Damsgaard, A. Frøland, S. Nielsen, N. de Fine Olivarius, A. Schmitz, Microalbuminuria in non-insulin dependent diabetes. Clin. Nephrol. 38, 528–538 (1992)

    Google Scholar 

  6. G.C. Viberti, R.D. Hill, R.J. Jarrett, A. Argyropoulos, U. Mahmud, H. Keen, Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet 1, 1430–1432 (1982)

    Article  CAS  PubMed  Google Scholar 

  7. E.R. Mathiesen, B. Rønn, B. Storm, H. Foght, T. Deckert, The natural course of microalbuminuria in insulin-dependent diabetes: a 10-year prospective study. Diabet. Med. 12, 482–487 (1995)

    Article  CAS  PubMed  Google Scholar 

  8. R. Sukhija, W.S. Aronow, P. Kakar, L. Garza, R. Sachdeva, A. Sinha, J.L. Mehta, Relation of microalbuminuria and coronary artery disease in patients with and without diabetes mellitus. Am. J. Cardiol. 98, 279–281 (2006)

    Article  CAS  PubMed  Google Scholar 

  9. G. Viberti, Etiology and prognostic significance of albuminuria in diabetes. Diabetes Care 11(10), 840–845 (1998)

    Article  Google Scholar 

  10. M.L. Bots, A.W. Hoes, P.J. Koudstaal, A. Hofman, D.E. Grobbee, Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 96, 1432–1437 (1997)

    CAS  PubMed  Google Scholar 

  11. C.D. Stehouwer, M.A. Gall, J.W. Twisk, E. Knudsen, J.J. Emeis, H.H. Parving, Increased urinary albumin excretion, endothelial dysfunction, and chronic low-grade inflammation in type 2 diabetes. Progressive, interrelated, and independently associated with risk of death. Diabetes 51, 1157–1165 (2002)

    Article  CAS  PubMed  Google Scholar 

  12. T. Jensen, J. Bjerre-Knudsen, B. Feldt-Rasmussen, T. Deckert, Features of endothelial dysfunction in early diabetic nephropathy. Lancet 1, 461–463 (1989)

    Article  CAS  PubMed  Google Scholar 

  13. T. Deckert, B. Feldt-Rasmussen, K. Borch-Johnsen, T. Jensen, A. Kofoed-Enevoldsen, Albuminuria reflects widespread vascular damage: the Steno hypothesis. Diabetologia 32, 219–226 (1989)

    Article  CAS  PubMed  Google Scholar 

  14. T. Deckert, T. Jensen, B. Feldt-Rasmussen, A. Kofoed-Enevoldeen, K. Borch-Johnsen, S. Stender, Albuminuria a risk marker of atherosclerosis in insulin dependent diabetes mellitus. Cardiovasc. Risk Factors 1, 347–360 (1991)

    Google Scholar 

  15. H. Yokoyama, T. Aoki, M. Imahori, M. Kuramitsu, Subclinical atherosclerosis is increased in type 2 diabetic patients with microalbuminuria evaluated by intima-media thickness and pulse wave velocity. Kidney Int. 66, 448–454 (2004)

    Article  PubMed  Google Scholar 

  16. A. Smith, J. Karalliedde, L. De Angelis, D. Goldsmith, G. Viberti, Aortic pulse wave velocity and albuminuria in patients with type 2 diabetes. J. Am. Soc. Nephrol. 16, 1069–1075 (2005)

    Article  PubMed  Google Scholar 

  17. C.D. Stehouwer, R.M. Henry, J.M. Dekker, G. Nijpels, R.J. Heine, L.M. Bouter, Microalbuminuria is associated with impaired brachial artery, flow-mediated vasodilation in elderly individuals without and with diabetes: further evidence for a link between microalbuminuria and endothelial dysfunction—The Hoorn Study. Kidney Int. 66, S42–S44 (2004)

    Article  Google Scholar 

  18. K. Aso, M. Miyata, T. Kubo, H. Hashiguchi, M. Fukudome, E. Fukushige, N. Koriyama, M. Nakazaki, S. Minagoe, C. Tei, Brachial-ankle pulse wave velocity is useful for evaluation of complications in type 2 diabetic patients. Hypertens. Res. 26, 807–813 (2003)

    Article  PubMed  Google Scholar 

  19. Y.P. Liu, W.W. Zhan, Y.F. Zhang, Y.H. Chen, Y.Y. Lin, Y. Zhu, X.P. Ren, X.Y. Li, G. Ning, Carotid intima-media thickness and stiffness in relation to type 2 diabetes in Chinese. Endocrine 31, 289–293 (2007)

    Article  CAS  PubMed  Google Scholar 

  20. M. Furtner, S. Kiechl, A. Mair, K. Seppi, S. Weger, F. Oberhollenzer, W. Poewe, J. Willeit, Urinary albumin excretion is independently associated with carotid and femoral artery atherosclerosis in the general population. Eur. Heart J. 26, 279–287 (2005)

    Article  CAS  PubMed  Google Scholar 

  21. J.M. Forbes, M.E. Cooper, M.D. Oldfield, M.C. Thomas, Role of advanced glycation end products in diabetic nephropathy. J. Am. Soc. Nephrol. 14, S254–S258 (2003)

    Article  CAS  PubMed  Google Scholar 

  22. W.T. Friedewald, R.I. Levy, D.S. Fredrickson, Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin. Chem. 18, 499–502 (1972)

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Clinical and laboratory results of the study participants were provided by Shanghai Clinical Center for Endocrine and Metabolic Diseases. The present study would not have been possible without the participation of the patients. We are sincerely indebted to Dr. Wang Jiguang for revision of the manuscript.

Author information

Authors and Affiliations

  1. Department of Ultrasonography, Ruijin Hospital, Shanghai Jiaotong University Medical School, 197 Ruijin 2nd Road, Shanghai, 200025, People’s Republic of China

    Wei-Wei Zhan, Ying Zhu, Yan-Yan Lin, Xin-Ping Ren & Yan-Ping Liu

  2. Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University Medical School, 197 Ruijin 2nd Road, Shanghai, 200025, People’s Republic of China

    Yu-Hong Chen, Yi-Fei Zhang & Xiao-Ying Li

Authors
  1. Wei-Wei Zhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yu-Hong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yi-Fei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ying Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yan-Yan Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xin-Ping Ren
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xiao-Ying Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yan-Ping Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yan-Ping Liu.

Additional information

Wei-Wei Zhan and Yu-Hong Chen have contributed equally to this article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhan, WW., Chen, YH., Zhang, YF. et al. Carotid stiffness and microalbuminuria in patients with type 2 diabetes. Endocr 35, 409–413 (2009). https://doi.org/10.1007/s12020-009-9172-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-009-9172-4

Keywords

Search

Navigation