Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
1.
J Diabetes Complications ; 31(6): 933-938, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28392041

ABSTRACT

AIM: Albuminuria progression has been associated with renal deterioration in type 2 diabetes (T2DM). Central arterial stiffness can aggravate systemic vasculopathy by propagating elevated systolic and pulse pressures forward, thereby accentuating global vascular injury. We aim to investigate whether central arterial stiffness is an independent predictor for albuminuria progression in a multi-ethnic T2DM Asian cohort in Singapore. METHODS: In a prospective cohort, 1012 T2DM patients were assessed at baseline and after a median follow-up of 3.1years. 880 patients with baseline normo- (urinary albumin-to-creatinine ratio (ACR)<30mg/g, n=579) and microalbuminuria (ACR=30-299mg/g, n=301) were divided into progression and non-progression groups according to ACR changes. Progression was defined as transition from normo- to microalbuminuria, micro- to macroalbuminuria, or normo- to macroalbuminuria. Central arterial stiffness was estimated by carotid-femoral pulse wave velocity (PWV) using applanation tonometry method. Stepwise multiple regression analysis was used to determine the predictor(s) for albuminuria progression. RESULTS: Albuminuria progression occurred in 178 patients (20.2%). Baseline PWV was higher in progression (10.1±2.9m/s) than non-progression group (9.2±2.4m/s, p<0.001). 1-SD increase in baseline PWV was associated with albuminuria progression (OR=1.457, 95% CI, 1.236-1.718, p<0.001). Stepwise regression analysis identified that baseline PWV (OR=1.241, 95% CI, 1.033-1.490, p=0.021), BMI (OR=1.046, 95% CI, 1.012-1.080, p=0.008), nature log-transformed estimated glomerular filtration rate (LneGFR) (OR=0.320, 95% CI, 0.192-0.530, p=0.010) and LnACR (OR=1.344, 95% CI, 1.187-1.522, p=0.008) are predictors for albuminuria progression. CONCLUSION: Increased central arterial stiffness at baseline predicted future progression of albuminuria. Our results suggest the potential benefit of ameliorating central arterial stiffness to retard albuminuria progression in T2DM.


Subject(s)
Albuminuria/diagnosis , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/diagnosis , Diabetic Nephropathies/diagnosis , Vascular Stiffness/physiology , Adult , Aged , Aged, 80 and over , Albuminuria/ethnology , Albuminuria/etiology , Albuminuria/pathology , Asian People , Cohort Studies , Cross-Sectional Studies , Diabetes Mellitus, Type 2/ethnology , Diabetes Mellitus, Type 2/pathology , Diabetic Nephropathies/ethnology , Diabetic Nephropathies/pathology , Disease Progression , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Prognosis , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/ethnology , Renal Insufficiency, Chronic/etiology , Risk Factors , Singapore/epidemiology , Young Adult
2.
Diab Vasc Dis Res ; 13(4): 303-6, 2016 07.
Article in English | MEDLINE | ID: mdl-27190079

ABSTRACT

OBJECTIVE: To examine the relationship between inflammation and central arterial stiffness in a type 2 diabetes Asian cohort. METHOD: Central arterial stiffness was estimated by carotid-femoral pulse wave velocity and augmentation index. Linear regression model was used to evaluate the association of high-sensitivity C-reactive protein and soluble receptor for advanced glycation end products with pulse wave velocity and augmentation index. High-sensitivity C-reactive protein was analysed as a continuous variable and categories (<1, 1-3, and >3 mg/L). RESULTS: There is no association between high-sensitivity C-reactive protein and pulse wave velocity. Augmentation index increased with high-sensitivity C-reactive protein as a continuous variable (ß = 0.328, p = 0.049) and categories (ß = 1.474, p = 0.008 for high-sensitivity C-reactive protein: 1-3 mg/L and ß = 1.323, p = 0.019 for high-sensitivity C-reactive protein: >3 mg/L) after multivariable adjustment. No association was observed between augmentation index and soluble receptor for advanced glycation end products. Each unit increase in natural log-transformed soluble receptor for advanced glycation end products was associated with 0.328 m/s decrease in pulse wave velocity after multivariable adjustment (p = 0.007). CONCLUSION: Elevated high-sensitivity C-reactive protein and decreased soluble receptor for advanced glycation end products are associated with augmentation index and pulse wave velocity, respectively, suggesting the potential role of systemic inflammation in the pathogenesis of central arterial stiffness in type 2 diabetes.


Subject(s)
Asian People , Diabetes Mellitus, Type 2/ethnology , Diabetic Angiopathies/ethnology , Inflammation/ethnology , Vascular Stiffness , Adult , Aged , Aged, 80 and over , Biomarkers/blood , C-Reactive Protein/analysis , Cross-Sectional Studies , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/physiopathology , Diabetic Angiopathies/blood , Diabetic Angiopathies/diagnosis , Diabetic Angiopathies/physiopathology , Female , Glycation End Products, Advanced/blood , Humans , Inflammation/blood , Inflammation/diagnosis , Inflammation/physiopathology , Inflammation Mediators/blood , Linear Models , Male , Middle Aged , Multivariate Analysis , Pulse Wave Analysis , Risk Factors , Singapore/epidemiology , Young Adult
3.
Article in English | WPRIM (Western Pacific) | ID: wpr-632769

ABSTRACT

@#<p><strong>OBJECTIVES:</strong> An inter-arm difference in systolic blood pressure (IADSBP) of 10 mmHg or more has been associated with cardiovascular disease (CVD) and increased mortality in T2DM patients. We aim to study ethnic disparity in IADSBP and its determinants in a multi-ethnic T2DM Asian cohort.<br /><strong>METHODOLOGY:</strong> Bilateral blood pressures were collected sequentially in Chinese (n=654), Malays (n=266) and Indians (n=313). IADSBP was analyzed as categories (<br /><strong>RESULTS:</strong> Malays (27.4%) and Indians (22.4%) had higher prevalence of IADSBP ?10 mmHg than Chinese (17.4%) (p=0.002). After adjustment for age, gender, duration of diabetes, hemoglobin A1c, body mass index (BMI), heart rate, pulse wave velocity (PWV), estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR), smoking, hypertension, soluble receptor for advanced glycation end products (sRAGE), and usage of hypertension medications, ethnicity remained associated with IADSBP. While Malays were more likely to have IADSBP ?10 mmHg than Chinese (OR=1.648, 95%CI: 1.138-2.400, p=0.009), Indians had comparable odds with the Chinese. BMI (OR=1.054, 95%CI: 1.022-1.087, p=0.001) and hypertension (OR=2.529, 95%CI: 1.811-3.533, p<0.001) were also associated with IADSBP ?10 mmHg.<br /><strong>CONCLUSION:</strong> IADSBP in Malays were more likely to be ?10 mmHg than the Chinese which may explain their higher risk for CVD and mortality. Measuring bilateral blood pressures may identify high-risk T2DM individuals for intensive risk factor-management.</p>


Subject(s)
Humans , Male , Female , Aged , Middle Aged , Adult , Young Adult , Blood Pressure , Cardiovascular Diseases , Mortality , Diabetes Mellitus , Body Mass Index , Hemoglobins , Heart Rate , Glomerular Filtration Rate , Creatinine , Smoking , Hypertension
SELECTION OF CITATIONS
SEARCH DETAIL
...