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Arterial stiffness increases with deteriorating glucose tolerance status: the Hoorn Study
Ronald M A Henry1, Piet J Kostense, Annemieke M W Spijkerman
1Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Circulation
|April 16, 2003
Summary
Type 2 diabetes (DM-2) and impaired glucose metabolism (IGM) significantly increase arterial stiffness, a key factor in cardiovascular disease risk. These changes in vascular health begin even before the onset of DM-2.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Vascular Biology
Background:
- Type 2 diabetes (DM-2) and impaired glucose metabolism (IGM) are linked to higher cardiovascular disease (CVD) risk.
- Increased arterial stiffness is a significant contributor to CVD in non-diabetic individuals.
- Systematic investigation of the association between DM-2, IGM, and arterial stiffness is lacking.
Purpose of the Study:
- To investigate the association between impaired glucose metabolism (IGM) and type 2 diabetes (DM-2) with arterial stiffness.
- To determine if arterial stiffness changes occur before the clinical diagnosis of DM-2.
- To identify factors contributing to increased arterial stiffness in individuals with IGM and DM-2.
Main Methods:
- A population-based cohort of 747 individuals was studied, categorized into normal glucose metabolism, IGM, and DM-2 groups.
- Arterial stiffness was assessed using ultrasound to measure distensibility, compliance, and elastic modulus of carotid, femoral, and brachial arteries.
- Statistical analyses were performed adjusting for age, sex, mean arterial pressure, and conventional cardiovascular risk factors.
Main Results:
- DM-2 was associated with increased stiffness in carotid, femoral, and brachial arteries.
- IGM was linked to increased stiffness in femoral and brachial arteries, but not the carotid artery.
- Arterial stiffness increased progressively from normal glucose metabolism to IGM and then to DM-2, with significant changes occurring before DM-2 onset.
Conclusions:
- Both IGM and DM-2 are associated with elevated arterial stiffness.
- A significant portion of arterial stiffening occurs prior to the development of DM-2.
- Conventional cardiovascular risk factors, hyperglycemia, and hyperinsulinemia do not fully explain the observed arterial stiffness increases.
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