Associations of Albuminuria and eGFR with Stiffness Parameter β in Type 2 Diabetes

The stiffness parameter β is a clinical index of arterial stiffness that reflects systemic atherosclerosis. Chronic kidney disease (CKD) is a major cardiovascular risk factor in type 2 diabetes; however, it remains unclear whether a reduced kidney function or albuminuria is more strongly associated with arterial stiffness. This study examined the relative associations of estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) with stiffness parameter β in patients with type 2 diabetes.

This cross-sectional study enrolled 1,924 patients with type 2 diabetes. The stiffness parameter β was assessed at the common carotid artery using ultrasonography.

The participants were 58.8% male, with a median age of 63 years and a median HbA1c level of 8.3%. According to univariate analyses, stiffness parameter β was significantly correlated with both eGFR and UACR. However, after adjusting for conventional cardiovascular risk factors, stiffness parameter β remained independently associated with UACR, whereas no independent association was observed with eGFR. Similar findings were observed when eGFR and albuminuria were analyzed according to the CKD categories. No significant interactions were observed between UACR and either age or body mass index in relation to stiffness parameter β.

In patients with type 2 diabetes, albuminuria, but not eGFR, was independently associated with stiffness parameter β after multivariable adjustment. These findings suggest that albuminuria may serve as a marker of local carotid arterial stiffening and vascular injury.