Change in Arterial Stiffness Is Associated With Change in Blood Glucose: Longitudinal Study in the Whitehall II...

Type 2 diabetes is associated with elevated large artery stiffening, but arterial stiffening may also precede the development of type 2 diabetes. Whether the change in arterial stiffness over time is associated with dysglycemia across the entire spectrum of blood glucose concentration is unknown. Therefore, the primary objective of this study was to quantify the association between the change in arterial stiffness (exposure) and glycemic concentration (outcome).

Within the prospective WHS II (Whitehall II Study), arterial stiffness was first measured in the 2007/09 examination round (baseline for the current study) and again in 2012/13, using the noninvasive, gold-standard method of carotid to femoral pulse wave velocity (cfPWV). Change in cfPWV was determined as cfPWV in 2012/13-cfPWV-cfPWV in 2007/09. Fasting blood glucose concentrations were measured at baseline (2007/09) and follow-up in 2012/13 and 2015/16.

There were 2632 participants without prior type 2 diabetes and cfPWV measured at 2 timepoints with follow-up in 2012/13 and 2282 with follow-up in 2015/16. Greater change in cfPWV was associated with significantly higher fasting glucose concentration at follow-up in 2012/13 and 2015/16 independently of confounders including cfPWV and fasting glucose levels at baseline (P<0.001 for both). Greater change in cfPWV was significantly and independently associated with a greater change in fasting glucose concentration over the same period (2007/09-2012/13) and beyond (2007/09-2015/16).

Minimizing premature arterial stiffening over time could be a valuable strategy for the prevention of glucose dysregulation and overt type 2 diabetes.