Relationship between Arterial Stiffness and Subsequent Cardiac Structure and Function in Young Adults with Youth-Onset Type 2 Diabetes: Results from the TODAY Study - 01/06/22
, Jeanie B. Tryggestad, MD e, Kristen J. Nadeau, MD f, Fida Bacha, MD g, Lorraine E. Levitt Katz, MD h, Steven M. Willi, MD h, Joao Lima, MD i, Elaine M. Urbina, MD, MS bfor the
TODAY Study Group
Abstract |
Background |
Higher arterial stiffness may contribute to future alterations in left ventricular systolic and diastolic function. We tested this hypothesis in individuals with youth-onset type 2 diabetes from the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study.
Methods |
Arterial stiffness (pulse wave velocity [carotid-femoral, femoral-foot, and carotid-radial], augmentation index, brachial distensibility) was measured in 388 participants with type 2 diabetes (mean age, 21 years; diabetes duration, 7.7 ± 1.5 years). To reflect overall (composite) vascular stiffness, the five arterial stiffness measures were aggregated. An echocardiogram was performed in the same cohort 2 years later. Linear regression models assessed whether composite arterial stiffness was associated with left ventricular mass index or systolic and diastolic function, independent of age, sex, race/ethnicity, current cigarette smoking, and long-term exposure (time-weighted mean values over 9.1 years) of hemoglobin A1c, blood pressure, and body mass index. Interactions among arterial stiffness and time-weighted mean hemoglobin A1c, blood pressure, and body mass were also examined.
Results |
After adjustment, arterial stiffness remained significantly associated with left ventricular mass index and diastolic function measured by mitral valve E/Em, despite attenuation by time-weighted mean body mass index. A significant interaction revealed a greater adverse effect of composite arterial stiffness on mitral valve E/Em among participants with higher levels of blood pressure over time. Arterial stiffness was unrelated to left ventricular systolic function.
Conclusions |
The association of higher arterial stiffness with future left ventricular diastolic dysfunction suggests the path to future heart failure may begin early in life in this setting of youth-onset type 2 diabetes.
Trial Registration |
ClinicalTrials.gov NCT00081328.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Youth-onset type 2 diabetes increases the risk for cardiovascular disease. |
• | Artery stiffening is associated with worse diastolic function 2 years later. |
• | This relationship was exacerbated by higher blood pressure. |
• | In this young cohort, cardiovascular disease is observed with effects on the heart and vessels. |
Keywords : Arterial stiffness, Cardiac structure, Diastolic function, Type 2 diabetes
Abbreviations : Aix, BP, BMI, BrachD, HbA1c, HDL, LA, LV, PWV, RV, TAPSE, T2D, TODAY, TODAY2
Plan
| Conflicts of Interest: None. |
|
| This work was completed with funding from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health Office of the Director through grants U01-DK61212, U01-DK61230, U01-DK61239, U01-DK61242, and U01-DK61254. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The NIDDK project office was involved in all aspects of the study, including design and conduct; collection, management, analysis, and interpretation of the data; review and approval of the manuscript; and decision to submit the manuscript for publication. |
Vol 35 - N° 6
P. 620 - juin 2022 Retour au numéro
Article précédent
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