Diabetology International

, Volume 9, Issue 1, pp 48–55 | Cite as

Relationships between the arterial velocity pulse index as a novel marker of atherosclerosis and biomarkers of cardiac or renal condition in patients with type 2 diabetes mellitus

Original Article
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Abstract

Background

The arterial velocity pulse index (AVI) has been explored as a novel marker of atherosclerosis using pulse wave analysis in the clinical setting. The aim of this study was to clarify the relationships between the AVI and biomarkers of cardiac or renal condition in patients with type 2 diabetes mellitus.

Methods

In total, 301 outpatients with type 2 diabetes mellitus (116 males and 185 females; mean age ± standard deviation: 63 ± 12 years) without a history of cardiovascular events were enrolled in this study. The AVI and biomarkers of cardiac or renal condition were measured using a commercial device, and the relationships between the AVI and the biomarkers were examined.

Results

The AVI was significantly associated with biomarkers of cardiac condition such as the blood levels of brain natriuretic peptide (r = 0.29, P < 0.001) and high-sensitivity cardiac troponin T (hs-cTnT) (r = 0.48, P < 0.001). The AVI was also significantly associated with biomarkers of renal condition such as the estimated glomerular filtration rate (r = −0.22, P < 0.001) and urinary albumin excretion (r = 0.42, P < 0.001). Multiple regression analysis revealed that hs-cTnT and urinary albumin excretion were independent variables that were correlated with the AVI when it was used as a subordinate factor.

Conclusion

The results of this study indicate that the AVI is significantly associated with hs-cTnT and urinary albumin excretion in patients with type 2 diabetes mellitus.

Keywords

Arterial velocity pulse index High-sensitivity troponin T Urinary albumin Skin autofluorescence Oxidative stress Type 2 diabetes mellitus 

Notes

Compliance with ethical standards

Conflict of interest

The author declares that there is no conflict of interest.

Human rights statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or a substitute for it was obtained from all patients before they were included in the study.

References

  1. 1.
    Zheng M, Huo Y, Wang X, Xu X, Qin X, Tang G, et al. A prospective study on pulse wave velocity (PWV) and response to anti-hypertensive treatments: PWV determines BP control. Int J Cardiol. 2015;178:226–31.CrossRefPubMedGoogle Scholar
  2. 2.
    Kubozono T, Ohishi M. Prognostic significance of regional arterial stiffness for stroke in hypertension. Pulse (Basel). 2015;3:98–105.CrossRefGoogle Scholar
  3. 3.
    Sueta D, Yamamoto E, Tanaka T, Hirata Y, Sakamoto K, Tsujita K, et al. The accuracy of central blood pressure waveform by novel mathematical transformation of non-invasive measurement. Int J Cardiol. 2015;189:244–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Sasaki-Nakashima R, Kino T, Chen L, Doi H, Minegishi S, Abe K, et al. Successful prediction of cardiovascular risk by new non-invasive vascular indexes using suprasystolic cuff oscillometric waveform analysis. J Cardiol. 2017;69:30–7.Google Scholar
  5. 5.
    Okamoto M, Nakamura F, Musha T, Kobayashi Y. Association between novel arterial stiffness indices and risk factors of cardiovascular disease. BMC Cardiovasc Disord. 2016;16:211.CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Asbun J, Villarreal FJ. The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopathy. J Am Coll Cardiol. 2006;47:693–700.CrossRefPubMedGoogle Scholar
  7. 7.
    Moriya T, Moriya R, Yajima Y, Steffes MW, Mauer M. Urinary albumin as an indicator of diabetic nephropathy lesions in Japanese type 2 diabetic patients. Nephron. 2002;91:292–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Hasegawa T, Asakura M, Eguchi K, Asanuma H, Ohara T, Kanzaki H, et al. Plasma B-type natriuretic peptide is a useful tool for assessing coronary heart disease risk in a Japanese general population. Hypertens Res. 2015;38:74–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Cramer GE, Brouwer MA, Vader HL, de Boer MJ, Pop GA, Pop VJ, et al. Highly sensitive cardiac troponin T and long-term mortality in a population of community-derived perimenopausal women: nested case–control study. Heart. 2013;99:528–33.CrossRefPubMedGoogle Scholar
  10. 10.
    Oh SW, Baek SH, Kim YC, Goo HS, Heo NJ, Na KY, et al. Mild decrease in estimated glomerular filtration rate and proteinuria are associated with all-cause and cardiovascular mortality in the general population. Nephrol Dial Transplant. 2012;27:2284–90.CrossRefPubMedGoogle Scholar
  11. 11.
    Gerstein HC, Mann JF, Yi Q, Zinman B, Dinneen SF, Hoogwerf B, Hallé JP, Young J, Rashkow A, Joyce C, Nawaz S, Yusuf S; HOPE Study Investigators. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA. 2001;286:421–6.Google Scholar
  12. 12.
    Meerwaldt R, Hartog JW, Graaff R, Huisman RJ, Links TP, den Hollander NC, et al. Increased accumulation of skin advanced glycation end-products precedes and correlates with clinical manifestation of diabetic neuropathy. J Am Soc Nephrol. 2005;16:3687–93.CrossRefPubMedGoogle Scholar
  13. 13.
    Okin PM, Devereux RB, Liu JE, Oikarinen L, Jern S, Kjeldsen SE, et al. Regression of electrocardiographic left ventricular hypertrophy predicts regression of echocardiographic left ventricular mass: the LIFE study. J Hum Hypertens. 2004;18:403–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Fridewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.Google Scholar
  16. 16.
    Mingels A, Jacobs L, Michielsen E, Swaanenburg J, Wodzig W, van Dieijen-Visser M. Reference population and marathon runner sera assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and I assays. Clin Chem. 2009;55:101–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Imai E, Horio M, Nitta K, Yamagata K, Iseki K, Hara S, Ura N, et al. Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease. Clin Exp Nephrol. 2007;11:41–50.CrossRefPubMedGoogle Scholar
  18. 18.
    Cesarone MR, Belcaro G, Carratelli M, Cornelli U, De Sanctis MT, Incandela L, et al. A simple test to monitor oxidative stress. Int Angiol. 1999;18:127–30.PubMedGoogle Scholar
  19. 19.
    Hayward CS, Kelly RP. Gender-related differences in the central arterial pressure waveform. J Am Coll Cardiol. 1997;30:1863–71.CrossRefPubMedGoogle Scholar
  20. 20.
    Smulyan H, Marchais SJ, Pannier B, Guerin AP, Safar ME, London GM. Influence of body height on pulsatile arterial hemodynamic data. J Am Coll Cardiol. 1998;31:1103–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ. The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol. 2000;525(Pt 1):263–70.CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, Hughes AD, Thurston H, O’Rourke M; CAFE Investigators; Anglo-Scandinavian Cardiac Outcomes Trial Investigators; CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006;113:1213–25.Google Scholar
  23. 23.
    Odaira M, Tomiyama H, Hashimoto H, Kojima I, Matsumoto C, Yoshida M, et al. Increased arterial stiffness weakens the relationship between wave reflection and the central pressure indexes in men younger than 60 years of age. Am J Hypertens. 2011;24:881–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Hitsumoto T. Factors associated with high-sensitivity cardiac troponin T in patients with type 2 diabetes mellitus. J Nippon Med Sch. 2015;82:274–80.CrossRefPubMedGoogle Scholar
  25. 25.
    Bai Y, Ye P, Luo L, Xiao W, Xu R, Wu H, et al. Arterial stiffness is associated with minimally elevated high-sensitivity cardiac, troponin T levels in a community-dwelling population. Atherosclerosis. 2011;218:493–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Gedikli O, Ozturk S, Yilmaz H, Baykan M, Kiris A, Durmus I, et al. Relationship between arterial stiffness and myocardial damage in patients with newly diagnosed essential hypertension. Am J Hypertens. 2008;21:989–93.CrossRefPubMedGoogle Scholar
  27. 27.
    Jungbauer CG, Riedlinger J, Buchner S, Birner C, Resch M, Lubnow M, et al. High-sensitive troponin T in chronic heart failure correlates with severity of symptoms, left ventricular dysfunction and prognosis independently from N-terminal pro-b-type natriuretic peptide. Clin Chem Lab Med. 2011;49:1899–906.CrossRefPubMedGoogle Scholar
  28. 28.
    Buiten MS, de Bie MK, Rotmans JI, Dekker FW, van Buren M, Rabelink TJ, et al. Serum cardiac troponin-I is superior to troponin-T as a marker for left ventricular dysfunction in clinically stable patients with end-stage renal disease. PLoS One. 2015;10:e0134245.CrossRefPubMedCentralPubMedGoogle Scholar
  29. 29.
    Jaroch J, Łoboz Grudzień K, Bociąga Z, Kowalska A, Kruszyńska E, Wilczyńska M, et al. The relationship of carotid arterial stiffness to left ventricular diastolic dysfunction in untreated hypertension. Kardiol Pol. 2012;70:223–31.PubMedGoogle Scholar
  30. 30.
    Pedrinelli R, Giampietro O, Carmassi F, Melillo E, Dell’Omo G, Catapano G, et al. Microalbuminuria and endothelial dysfunction in essential hypertension. Lancet. 1994;344:14–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Donald AE, Halcox JP, Charakida M, Storry C, Wallace SM, Cole TJ, et al. Methodological approaches to optimize reproducibility and power in clinical studies of flow-mediated dilation. J Am Coll Cardiol. 2008;51:1959–64.CrossRefPubMedGoogle Scholar
  32. 32.
    Thijssen DH, Black MA, Pyke KE, Padilla J, Atkinson G, Harris RA, et al. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol. 2011;300:H2–12.CrossRefPubMedGoogle Scholar
  33. 33.
    Brownlee M, Cerami A, Vlassara H. Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. N Engl J Med. 1988;318:1315–21.CrossRefPubMedGoogle Scholar
  34. 34.
    Yamagishi S, Nakamura K, Imaizumi T. Advanced glycation end products (AGEs) and diabetic vascular complications. Curr Diabetes Rev. 2005;1:93–106.CrossRefPubMedGoogle Scholar
  35. 35.
    Ueno H, Koyama H, Tanaka S, Fukumoto S, Shinohara K, Shoji T, et al. Skin autofluorescence, a marker for advanced glycation end product accumulation, is associated with arterial stiffness in patients with end-stage renal disease. Metabolism. 2008;57:1452–7.CrossRefPubMedGoogle Scholar
  36. 36.
    Wang CC, Wang YC, Wang GJ, Shen MY, Chang YL, Liou SY, et al. Skin autofluorescence is associated with endothelial dysfunction in uremic subjects on hemodialysis. PLoS One. 2016;11:e0147771.CrossRefPubMedCentralPubMedGoogle Scholar
  37. 37.
    Eguchi K, Boden-Albala B, Jin Z, Rundek T, Sacco RL, Homma S, Di Tullio MR. Association between diabetes mellitus and left ventricular hypertrophy in a multiethnic population. Am J Cardiol. 2008;101:1787–91.CrossRefPubMedCentralPubMedGoogle Scholar
  38. 38.
    Dawson A, Morris AD, Struthers AD. The epidemiology of left ventricular hypertrophy in type 2 diabetes mellitus. Diabetologia. 2005;48:1971–9.CrossRefPubMedGoogle Scholar
  39. 39.
    Hashimoto J, Watabe D, Hatanaka R, Hanasawa T, Metoki H, Asayama K, et al. Enhanced radial late systolic pressure augmentation in hypertensive patients with left ventricular hypertrophy. Am J Hypertens. 2006;19:27–32.CrossRefPubMedGoogle Scholar
  40. 40.
    Kotani K, Yamada T. Association between urinary 8-OHdG and pulse wave velocity in hypertensive patients with type 2 diabetes mellitus. Singapore Med J. 2014;55:202–8.CrossRefPubMedCentralPubMedGoogle Scholar
  41. 41.
    Mokhaneli MC, Fourie CM, Botha S, Mels CM. The association of oxidative stress with arterial compliance and vascular resistance in a bi-ethnic population: the SABPA study. Free Radic Res. 2016;50:920–8.CrossRefPubMedGoogle Scholar

Copyright information

© The Japan Diabetes Society 2017

Authors and Affiliations

  1. 1.Hitsumoto Medical ClinicShimonoseki-CityJapan

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