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Aortic distensibility in type 1 diabetes

Evrim B Turkbey1, Alban Redheuil, Jye-Yu C Backlund

  • 1Radiology and Imaging Sciences, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland, USA.

Diabetes Care
|March 12, 2013
PubMed

Insights

Long-term high blood sugar and high blood pressure significantly increase aortic stiffness in type 1 diabetes patients. Macroalbuminuria also contributes to this dangerous arterial stiffening.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Diabetology

Background:

  • Type 1 diabetes is associated with an increased risk of cardiovascular disease (CVD).
  • Arterial stiffness, particularly of the ascending aorta, is an independent predictor of CVD events.
  • The impact of long-term glycemic control and traditional CVD risk factors on aortic stiffness in type 1 diabetes requires further elucidation.

Purpose of the Study:

  • To investigate the relationship between long-term glycemic control (HbA1c), traditional cardiovascular disease (CVD) risk factors, and ascending aortic (AA) stiffness.
  • To assess the influence of macroalbuminuria on AA stiffness in individuals with type 1 diabetes.

Main Methods:

  • Utilized data from 879 participants in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study.
  • Measured ascending thoracic aorta (AA) stiffness and distensibility using magnetic resonance imaging.
  • Employed multivariate linear regression models to analyze associations between AA distensibility, CVD risk factors, mean HbA1c, and cardiovascular complications.

Main Results:

  • Lower AA distensibility was observed with increasing age, higher systolic blood pressure, elevated LDL cholesterol, and higher mean HbA1c over 22 years.
  • Macroalbuminuria was associated with a 25% reduction in AA distensibility (P < 0.0001).
  • Increased left ventricular mass to volume ratio also correlated with reduced AA distensibility.

Conclusions:

  • Chronic hyperglycemia, hypertension, and macroalbuminuria exert significant adverse effects on ascending aortic stiffness in type 1 diabetes.
  • These findings highlight the detrimental impact of metabolic and hemodynamic factors on vascular health in this population.
Abstract

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