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Published on: October 22, 2014
Reduced brachial artery distensibility in patients with type 1 diabetes
Philip Ljunggren1, David M Maahs2, Per Johansson1
1Medical Faculty, Linköping University, 582 25, Linköping, Sweden.
Insights
Type 1 diabetes (T1D) is linked to reduced brachial artery distensibility (BrachD), a marker of vascular stiffness and cardiovascular disease risk. This decline is more pronounced in women with T1D as they age.
Area of Science:
- Vascular Medicine
- Cardiovascular Health
- Endocrinology
Background:
- Type 1 diabetes (T1D) significantly increases the risk of premature cardiovascular disease (CVD) compared to the general population.
- Reduced brachial artery distensibility (BrachD) is an established independent risk factor for CVD development.
- Understanding factors influencing BrachD in T1D is crucial for early CVD risk assessment.
Purpose of the Study:
- To compare BrachD in adults with and without T1D.
- To investigate the influence of age and gender on the relationship between T1D status and BrachD.
- To identify potential non-invasive markers for CVD risk in T1D patients.
Main Methods:
- BrachD was measured using the Dynapulse instrument in 829 participants, including 352 with T1D and 477 controls.
- Analysis of Covariance (ANCOVA) was employed to assess associations between BrachD, age, sex, and T1D status.
- A specific analysis examined the interaction effect of age, sex, and T1D on BrachD.
Main Results:
- Mean BrachD was significantly lower in individuals with T1D compared to non-diabetic controls (p<0.0001).
- A significant interaction effect of age*T1D*sex (p=0.0045) was observed, indicating differential effects based on these factors.
- While younger women had higher BrachD than men, older women exhibited lower BrachD than older men, with women with T1D showing a steeper age-related decline.
Conclusions:
- Individuals with T1D exhibit reduced brachial artery distensibility, suggesting increased vascular stiffness and heightened CVD risk.
- Age and gender significantly modify the impact of T1D on BrachD, with women experiencing a more rapid decline.
- BrachD presents a potential non-invasive and cost-effective tool for assessing elevated CVD risk in the T1D population.
Background And Aims:
In patients with type 1 diabetes mellitus (T1D), cardiovascular disease (CVD) events are more common and occur earlier in life than in non-diabetics. Reduced brachial artery distensibility (BrachD) is an independent risk factor for development of CVD. Our aim was to determine if adults with T1D have lower BrachD compared to adults without diabetes and also to determine how age and gender affect the relationship of BrachD with T1D status.
Materials And Methods:
BrachD was measured using the Dynapulse instrument in 829 participants (352 with T1D, 477 non-diabetics). An ANCOVA model was used to test the association of BrachD with age, sex, and T1D, and the significance of an age*sex*T1D interaction.
Results:
Mean BrachD was lower in T1D patients vs. controls (6.43±1.46 vs. 7.16±1.48 % change per mmHg, p<0.0001). In a model adjusted for age, T1D, and sex, the interaction of age*T1D*sex was significant (p=0.0045). Younger women both with and without T1D had higher BrachD than men with and without T1D, but older women with and without T1D had lower BrachD compared to older men with and without T1D. Women with T1D had a steeper decline in BrachD with age than nondiabetic women.
Conclusions:
BrachD is lower in T1D patients than in non-diabetics, indicating increased vascular stiffness. Younger females have higher BrachD than males, but the decline with age in BrachD is steeper for women, particularly among those with T1D. BrachD may be an inexpensive, non-invasive method to ascertain increased CVD risk in this population.
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