Effect of aortic pulse wave velocity on target organ damage among older patients with type 2 diabetes mellitus / 预防医学

ABSTRACT

Objective To evaluate the association between aortic arterial stiffness and target organ damage, including renal function decline and left ventricular diastolic dysfunction among elderly diabetic patients and to provide theoretical basis for early prevention and intervention. Methods Brachial-ankle-artery pulse wave velocity(baPWV)reflecting aortic arterial stiffness was observed in 151 diabetic patients with(n=78)or without hypertension(n=73). Clinical data were collected, cardiac structure and function were assessed by echocardiography. Estimated glomerular filtration rate(eGFR)was calculated by CKD-EPI fomula. Results Of 151 subjects, the average age was(75.05±10.13)years and the average baPWV values was (1 803.85±491.04)mm/s. Patients with both diabetes and hypertension had significantly higher baPWV values[(2006.49± 536.70)mm/s]than that of diabetic patients[(1596.96 ±331.02)mm/s, P<0.01]. Multiple linear regression analysis demonstrated that baPWV was negatively associated with E/A ratio and eGFR(β'=-0.249, -0.225, P<0.05), but positively associated with hypertension(β'=2.008, P<0.05). By applying area under the receiver operator characteristic curve, baPWV had powerful predictive power for renal impairment(AUC=0.695, 95% CI 0.548-0.842)and left ventricular diastolic dysfunction(AUC=0.687, 95%CI 0.532-0.842). Conclusion Patients with both diabetes and hypertension had significantly higher baPWV values than that of diabetic patients. Higher baPWV was independently associated with greater burden of sub-clinical disease in renal impairment and left ventricular diastolic dysfunction.