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Type 2 Diabetes Mellitus, Hypertension, and HbA1c, as Risk Factors for Arterial Stiffness

Jorge Juarez Vieira Teixeira*, Rafaela Pelisson Regla, Rogerio Toshiro Passos Okawa, Edilson Almeida de Oliveira, Rafael Campos do Nascimento, Milene Cripa Pizatto de Araujo, Giovanna Chiqueto Duarte, Lorena Lima Gargaro, Marina Franciscon Gomes da Cruz, Alex Cardoso Perez, Guilherme Norio Hayakawa, Barbara Leticia da Silva Guedes de Moura

Studies in a healthy and diabetic population have shown that there is a correlation between the disease and arterial stiffness, and consequently an increase in Pulse Wave Velocity (PWV). Little is known about risk factors of arterial stiffness particularly regarding the prediction of type 2 diabetes mellitus. We investigate predictors laboratory and clinical associated with arterial stiffness, validated by the increase in PWV. All patients of BioCor Cardiology Center, in the city of Maringa, Parana, Brazil, were subject to a cross-sectional study in the period from 2010 to 2016. A non-invasive oscillometric device, the Mobil^®-o-graph, was used to measure the central pressure and pulse wave velocity. The analyses were conducted using Stata 9.0 (StataCorp, College Station, TX 77845 USA). This research was approved by the Local Ethics Committee (Permanent Ethics Committee in Human Research of the State University of Maringá), approval number 1.664.157/2016. The population was 1197 patients, mean age of 60.1 [SD ± 14.6], and 341 (28.5%) of these patients had altered PWV. The variables impacting for PWV ≥ 10, with statistical significance for p<0.001 were: Type 2 diabetes mellitus (D2M), hypertension, HbA1c ≥ 5.7, total cholesterol ≥ 190 mg/dl, LDL cholesterol ≥ 130 mg/dl, and HDL cholesterol ≤ 40 md/dl, besides the known factor hypertension. The final model showed a positive association for PWV ≥10 for the presence of DM (OR 1.5, CI 1.0-2.3, p=0.040), hypertension (OR 2.7, CI 1.9-3.9, p<0.001), HbA1c 5.7-6.4 (OR 2.1, 1.5-2.9, p<0.001), HbA1c ≥ 6.5 (OR 3.6, 2.2-2.8, p<0.001), and HDL cholesterol ≤ 40 md/dl (OR 1.4, IC 1.0-1.8, p=0.031). Our findings showed that the predictor for D2M, hypertension, glycated hemoglobin ≥ 5.7, confirmed the significant association for increased arterial stiffness, validated by the increase in PWV.