TY - JOUR
TI - Clinical interaction between diabetes duration and aortic stiffness in type 2 diabetes mellitus
AU - Agnoletti, D.
AU - Mansour, A.S.
AU - Zhang, Y.
AU - Protogerou, A.D.
AU - Ouerdane, S.
AU - Blacher, J.
AU - Safar, M.E.
JO - Journal of Human Hypertension
PY - 2017
VL - 31
TODO - 3
SP - 189-194
PB - Nature Publishing Group
SN - 0950-9240, 1476-5527
TODO - 10.1038/jhh.2016.58
TODO - adult;  age;  Algeria;  anthropometry;  arterial stiffness;  Article;  blood pressure;  cardiovascular disease;  carotid artery pulse;  circulation;  clinical study;  controlled study;  correlational study;  diabetes control;  disease association;  disease control;  disease duration;  female;  femoral artery;  France;  heart rate;  human;  insulin treatment;  intersectoral collaboration;  kidney dysfunction;  kidney function;  macrocirculation;  major clinical study;  male;  metabolic syndrome X;  microalbuminuria;  microcirculation;  middle aged;  non insulin dependent diabetes mellitus;  prevalence;  pulse wave;  sex difference;  aged;  albuminuria;  cardiovascular disease;  complication;  cross-sectional study;  microcirculation;  non insulin dependent diabetes mellitus;  pathophysiology, Adult;  Aged;  Albuminuria;  Cardiovascular Diseases;  Cross-Sectional Studies;  Diabetes Mellitus, Type 2;  Female;  Humans;  Male;  Microcirculation;  Middle Aged;  Pulse Wave Analysis;  Vascular Stiffness
TODO - Diabetes complications increase with disease duration. No study was performed on the relationship between aortic stiffness and diabetes duration, taking into account the respective influence of such factors on macro- and microcirculation. In total, 618 subjects with type 2 diabetes (259 men) attending the Department of Internal Medicine of Tizi Ouzou Hospital (Algeria) were studied in collaboration with Hotel-Dieu Hospital (Paris, France). Brachial blood pressure (BP), anthropometric, clinical and biological data were evaluated. Aortic stiffness was estimated by carotid-femoral pulse wave velocity (PWV). From lower to higher tertile of diabetes duration, age, BP and PWV (10.1±2.7 to 12.3±2.8 m s-1) increased, while diabetes control and renal function worsened (all P<0.01). Diabetes duration was independently associated with PWV (R2 =0.035, P<0.0001), even after adjustment for age, BP, heart rate, cardiovascular events and metabolic syndrome. Diabetes duration was significantly correlated to the prevalence of microalbuminuria (OR (95% CL) 1.3 (1.06-1.63), P=0.01), independently of age, sex, BP and renal function. Increased aortic stiffness was independently associated with the prevalence of cardiovascular events (P<0.001), reaching its maximal value above the first 2 years of diabetes duration. In conclusion, diabetes duration is an independent determinant of aortic stiffness in subjects with type 2 diabetes, representing about 4% of PWV variability. Diabetes duration is associated with microvascular complications independently of renal function, and with macrovascular complications through the presence of increased aortic stiffness. © 2017 Macmillan Publishers Limited, part of Springer Nature.
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