Arterial Stiffness Is Increased in Patients With Type 1 Diabetes Without Cardiovascular Disease
A potential role of low-grade inflammation
- Gemma Llauradó, MD1,
- Victòria Ceperuelo-Mallafré, MD, PHD2,3,
- Carme Vilardell, MD, PHD4,
- Rafael Simó, MD, PHD5,
- Núria Freixenet, MD1,
- Joan Vendrell, MD, PHD3 and
- José Miguel González-Clemente, MD, PHD1⇓
- 1Department of Diabetes, Endocrinology, and Nutrition, Hospital of Sabadell, Corporació Sanitària i Universitària Parc Taulí (Universitat Autònoma de Barcelona), Sabadell, Spain
- 2Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Hospital Clínico Virgen de la Victoria, Málaga, Spain the
- 3Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Hospital Universitari Joan XXIII de Tarragona, Insitut Pere Virgili, Universitat Rovira i Virgili, Tarragona, Spain; the
- 4Diabetes, Endocrinology, and Nutrition Unit, Hospital Sant Joan de Déu de Manresa, Xarxa Assistencial Althaia, Manresa, Spain
- 5Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) and Diabetes and Metabolism Research Unit, Institut de Recerca Hospital Universitari Vall d’Hebrón (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Corresponding author: José Miguel González-Clemente, .
OBJECTIVE To investigate the relationship between arterial stiffness and low-grade inflammation in subjects with type 1 diabetes without clinical cardiovascular disease.
RESEARCH DESIGN AND METHODS Sixty-eight patients with type 1 diabetes and 68 age- and sex-matched healthy subjects were evaluated. Arterial stiffness was assessed by aortic pulse wave velocity (aPWV). Serum concentrations of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, and soluble fractions of tumor necrosis factor-α receptors 1 and 2 (sTNFαR1 and sTNFαR2, respectively) were measured. All statistical analyses were stratified by sex.
RESULTS Subjects with diabetes had a higher aPWV compared with healthy control subjects (men: 6.9 vs. 6.3 m/s, P < 0.001; women: 6.4 vs. 6.0 m/s, P = 0.023). These differences remained significant after adjusting for cardiovascular risk factors. Men with diabetes had higher concentrations of hsCRP (1.2 vs. 0.6 mg/L; P = 0.036), IL-6 (0.6 vs. 0.3 pg/mL; P = 0.002), sTNFαR1 (2,739 vs. 1,410 pg/mL; P < 0.001), and sTNFαR2 (2,774 vs. 2,060 pg/mL; P < 0.001). Women with diabetes only had higher concentrations of IL-6 (0.6 vs. 0.4 pg/mL; P = 0.039). In men with diabetes, aPWV correlated positively with hsCRP (r = 0.389; P = 0.031) and IL-6 (r = 0.447; P = 0.008), whereas in women with diabetes no significant correlation was found. In men, multiple linear regression analysis showed that the following variables were associated independently with aPWV: age, BMI, type 1 diabetes, and low-grade inflammation (R2 = 0.543). In women, these variables were age, BMI, mean arterial pressure, and type 1 diabetes (R2 = 0.550).
CONCLUSIONS Arterial stiffness assessed as aPWV is increased in patients with type 1 diabetes without clinical cardiovascular disease, independently of classical cardiovascular risk factors. In men with type 1 diabetes, low-grade inflammation is independently associated with arterial stiffness.
- Received August 22, 2011.
- Accepted January 6, 2012.
- © 2012 by the American Diabetes Association.
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