Association Of Aortic Stiffness And Microvascular Complications In Type 2 Diabetes Mellitus
Abstract
Background: Arterial stiffness (AS) is considered to be an age-related progressive and continuous process which is a shared consequence of various different diseases inclusive of diabetes mellitus (DM), hypertension, the metabolic syndrome and chronic kidney disease (CKD).The present study was carried out with an aim to assess AS in patients with type 2 diabetes mellitus patients.
Material and methods: This cross sectional observational study was carried out from January 2022 to December 2022. A total of 250 samples were collected from all the patients attending General Medicine Department. All the patient microvascular complication was assessed by fundoscopy, presence of microalbumunuria and monofilament test. Statistical analysis was carried out using SPSS version 22.0.
Results: The mean age of the participants was 51.2 ± 8.5 years, with the majority (58.4%) ranging between the age group of 46–60 years. With an increasing duration of DM, the number of patients with aortic stiffness increased significantly. (p<0.001) Additionally, aortic stiffness was identified in the majority of individuals with microvascular complications.
Conclusion: Regular screening for AS is recommended for patients with DM and higher frequency of screening may be required in patients who are diabetic for a longer duration, old age and patients with micro vascular complications of DM.
Downloads
Metrics
References
Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. The lancet. 2010 Jun 26;375(9733):2215-22.
World Health Organization. "Global Report on Diabetes." World Health Organization (2016).
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS medicine. 2006 Nov 28;3(11):e442.
Maiti S, Akhtar S, Upadhyay AK, Mohanty SK. Socioeconomic inequality in awareness, treatment and control of diabetes among adults in India: Evidence from National Family Health Survey of India (NFHS), 2019–2021. Scientific reports. 2023 Feb 20;13(1):2971.
Prenner SB, Chirinos JA. Arterial stiffness in diabetes mellitus. Atherosclerosis. 2015 Feb 1;238(2):370-9.
Rodgers M, Hodges R, Hawkins J, Hollingworth W, Duffy S, McKibbin M, Mansfield M, Harbord R, Sterne J, Glasziou P, Whiting P. Colour vision testing for diabetic retinopathy: a systematic review of diagnostic accuracy and economic evaluation. Health Technol Assess. 2009 Dec 1;13(60):1-60.
Polkinghorne KR. Estimated glomerular filtration rate versus albuminuria in the assessment of kidney function: what’s more important?. The Clinical Biochemist Reviews. 2014 May;35(2):67.
Hsieh ST. Pathology and Functional Diagnosis of Small-fiber Painful Neuropathy. Acta Neurol Taiwan. 2010;19:82–89.
Niruba R, Subha K, Vijayalakshmi I. Assessment of Arterial Stiffness among Middle Aged Offspring of Diabetic Parents. International Journal of Current Research and Review 2014;6:31.)
Smulyan H, Lieber A, Safar ME. Hypertension, diabetes type II, and their association: role of arterial stiffness. American journal of hypertension 2015;29:5-13.
Xia F, Liu G, Shi Y, Zhang Y. Impact of microalbuminuria on incident coronary heart disease, cardiovascular and all-cause mortality: a meta-analysis of prospective studies. International journal of clinical and experimental medicine. 2015 Jan 15;8(1):1
Yokoyama H, Aoki T, Imahori M, Kuramitsu M. Subclinical atherosclerosis is increased in type 2 diabetic patients with microalbuminuria evaluated by intima-media thickness and pulse wave velocity. Kidney Int 2004;66:448-54
Smith A, Karalliedde J, De Angelis L, Goldsmith D, Viberti G. Aortic pulse wave velocity and albuminuria in patients with type 2 diabetes. J Am Soc Nephrol 2005;16:1069-75.
Pannier B, Guerin AP, Marchais SJ, Safar ME, London GM. Stiffness of capacitive and conduit arteries: prognostic significance for end-stage renal disease patients. Hypertension 2005;45:592-6.
Nakagawa N, Takahashi F, Chinda J, Kobayashi M, Hayashi Y, Abe M, et al. A newly estimated glomerular filtration rate is independently associated with arterial stiffness in Japanese patients. Hypertension Research 2008;31:193
Targher G, Bertolini L, Zenari L, Lippi G, Pichiri I, Zoppini G, et al. Diabetic retinopathy is associated with an increased incidence of cardiovascular events in Type 2 diabetic patients. Diabetic medicine : a journal of the British Diabetic Association 2008;25:45-50
Kramer CK, Rodrigues TC, Canani LH, Gross JL, Azevedo MJ. Diabetic retinopathy predicts all-cause mortality and cardiovascular events in both type 1 and 2 diabetes: meta-analysis of observational studies. Diabetes Care 2011;34:1238-44
Juutilainen A, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Retinopathy predicts cardiovascular mortality in type 2 diabetic men and women. Diabetes Care 2007;30:292-9.
Yun YW, Shin MH, Lee YH, Rhee JA, Choi JS. Arterial stiffness is associated with diabetic retinopathy in Korean type 2 diabetic patients. Journal of preventive medicine and public health = Yebang Uihakhoe chi 2011;44:260-6.
Ogawa O, Hayashi C, Nakaniwa T, Tanaka Y, Kawamori R. Arterial stiffness is associated with diabetic retinopathy in type 2 diabetes. Diabetes research and clinical practice 2005;68:162-6.)
Tanaka K, Kawai T, Saisho Y, Meguro S, Harada K, Satoh Y, et al. Relationship between stage of diabetic retinopathy and pulse wave velocity in Japanese patients with type 2 diabetes. Journal of diabetes research 2013;2013.
Chen HS, Hwu CM, Kuo BI, Chiang SC, Kwok CF, Lee SH, et al. Abnormal cardiovascular reflex tests are predictors of mortality in Type 2 diabetes mellitus. Diabetic medicine : a journal of the British Diabetic Association 2001;18:268-73
Zhang X, Liu JJ, Sum CF, Ying YL, Tavintharan S, Ng XW, Low S, Lee SB, Tang WE, Lim SC. Ethnic disparity in central arterial stiffness and its determinants among Asians with type 2 diabetes. Atherosclerosis. 2015 Sep 1;242(1):22-8.
Nazarzadeh M, Bidel Z, Canoy D, Copland E, Wamil M, Majert J, Byrne KS, Sundström J, Teo K, Davis BR, Chalmers J. Blood pressure lowering and risk of new-onset type 2 diabetes: an individual participant data meta-analysis. The Lancet. 2021 Nov 13;398(10313):1803-10.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Suresh Kumar, Arun Prasad, Sujhithra A
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
