Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pinto, E. S.
Right arrow Articles by Rajkumar, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pinto, E. S.
Right arrow Articles by Rajkumar, C.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Diabetes Care 28:496, 2005
© 2005 by the American Diabetes Association, Inc.

Letters: Observations

Peripheral Arterial Compliance Differs Between Races

Comparison among Asian, Afro-Caribbeans, and white Caucasians with type 2 diabetes

Elisabete S. Pinto, BSC, PHD1, Raphaela Mensah, BSC, MBBS1, Karim Meeran, BSC, MD, FRCP1, James D. Cameron, MENGSC, MD2, Nirupa Murugaesu, MBBS1, Christopher J. Bulpitt, MD, FRCP1 and Chakravarthi Rajkumar, MD, PHD, FRCP1

1 Section of Care of the Elderly, Division of Medicine, Hammersmith Hospital, Imperial College, London, U.K
2 Department of Vascular Sciences, Dandenong Hospital, Southern Health Network and Monash University, Melbourne, Australia

Address correspondence to Chakravarthi Rajkumar, Imperial College, Section of Care of Elderly, Hammersmith Hospital, Du Cane Road, London W12 0NN, U.K. E-mail: c.rajkumar{at}imperial.ac.uk

Patients with type 2 diabetes have two to three times the risk of dying prematurely from cardiovascular disease than their nondiabetic counterparts (1). Many studies have shown that arterial compliance is reduced in type 2 diabetes and that arterial stiffness increases with deteriorating glucose tolerance status, even before the onset of type 2 diabetes (2–4). In a previous brief report, we studied Afro-Caribbean and white Caucasian subjects with diabetes and found a decrease in peripheral arterial compliance in the Afro-Caribbean subjects (5). We also reported an accelerated rate of aging in the elastic arteries of diabetic patients reaching a plateau by the age of 50–60 years (6). The present article examines the control versus diabetic differences in two races, white Caucasians and Afro-Caribbeans, and includes data on Asians from the Indian subcontinent with diabetes.

Fifty-seven patients with a diagnosis of type 2 diabetes for at least 1 year (21 white Caucasian, 20 Afro-Caribbean, and 16 Asian) aged 44–80 years (mean ± SD 61 ± 7.4) and 48 healthy control subjects (30 white Caucasian and 18 Afro-Caribbean) aged 34–86 years (65.5 ± 11.6) took part in this cross-sectional study.

Pulse wave velocity of the carotidfemoral (PWVcf) was measured noninvasively in a thoraco-abdominal segment and in an upper-limb muscular artery (PWV of the carotid-radial [PWVcr]) using the Complior (Colson, Pantin, France) system. PWV from the aorta to the finger (PWVfin) was measured using the Finapress (Ohmeda, Madison, WI) and custom-written software (J.D.C.). Central aortic compliance (CAC) was also assessed from simultaneous measurements of ascending aortic blood flow and surrogate estimates of aortic root pressure using a method described by Liu et al. (7) and previously reported by Cameron et al. (8).

Analysis of the clinical characteristics of the participants for the diabetic and control groups and by ethnicity showed that for the diabetic group, only BMI was significantly different between the races (P < 0.05), with the white patient group having the highest mean value (29.9 kg/m2). For the control population, only age was significantly different (P = 0.01), with Caucasians being on average 8 years older than Afro-Caribbeans.

Race was found to be a major determinant of PWVcr in type 2 diabetic subjects, with Afro-Caribbeans having the highest mean value (12.10 ± 1.4 m/s) of the three ethnic origins (P = 0.03) compared with Caucasians (11.12 ± 1.3 m/s) and Asians (10.95 ± 1.3 m/s). The racial differences were independent of blood pressure. No differences were found between the races for PWVcf, PWVfin, or CAC. Analysis in the control population showed no differences in arterial compliance between the Afro-Caribbeans and Caucasians.

We have shown that there is a racial preponderance of stiffening of the peripheral arteries in diabetic subjects, with subjects of Afro-Caribbean origin having significantly higher mean indexes for PWVcr compared with those of white and Asian origin. Diabetes led to a decrease in the compliance of the aorto-iliac-femoral segment of the arterial system (PWVcf). The muscular arteries of diabetic subjects of Afro-Caribbean origin tended to have a reduced compliance. This difference could reflect the increased complications observed in Afro-Caribbeans with type 2 diabetes.

References

  1. Lehmann ED, Riley WA, Clarkson P, Gosling RG: Non-invasive assessment of cardiovascular disease in diabetes mellitus. Lancet 350 (Suppl. 1):14–19, 1997
  2. McVeigh GE: Arterial compliance in hypertension and diabetes mellitus. Am J Nephrol 16:217–222, 1996[Medline]
  3. Lehmann ED, Gosling RG, Sonksen PH: Arterial wall compliance in diabetes. Diabet Med 9:114–119, 1992[Medline]
  4. Henry RMA, Kostense PJ, Spijkerman AMW, Decker JM, Nijpels G, Heine RJ, Kamp O, Westerhof N, Bouter LM, Stephouwer CDA: Arterial stiffness increases with deteriorating glucose tolerance status: the Hoorn Study. Circulation 107:2089–2095, 2003[Abstract/Free Full Text]
  5. Rajkumar C, Mensah R, Meeran K, Armstrong S, Bulpitt CJ: Peripheral arterial compliance is lower in Afro-Caribbeans compared to white Caucasians with type 2 diabetes after adjustment for blood pressure. J Hum Hypertens 13:841–843, 1999[Medline]
  6. Cameron JD, Bulpitt CJ, Pinto ES, Rajkumar C: The aging of elastic and muscular arteries: a comparison of diabetic and nondiabetic subjects. Diabetes Care 26:2133–2138, 2003[Abstract/Free Full Text]
  7. Liu Z, Brin KP, Yin FCP: Estimation of total arterial compliance: an improved method and evaluation of current methods. Am J Physiol 251:H588–H600, 1986
  8. Cameron JD, Rajkumar C, Kingwell BA, Jennings GL, Dart AM: Higher systemic arterial compliance is associated with greater exercise time and lower blood pressure in young older population. J Am Geriatr Soc 47:653–656, 1999[Medline]

Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Age AgeingHome page
F. Fantin, A. Mattocks, C. J. Bulpitt, W. Banya, and C. Rajkumar
Is augmentation index a good measure of vascular stiffness in the elderly?
Age Ageing, January 1, 2007; 36(1): 43 - 48.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
B Jani and C Rajkumar
Ageing and vascular ageing.
Postgrad. Med. J., June 1, 2006; 82(968): 357 - 362.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pinto, E. S.
Right arrow Articles by Rajkumar, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pinto, E. S.
Right arrow Articles by Rajkumar, C.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum