Associations of Blood Biomarkers with Arterial Stiffness in Patients with Diabetes Mellitus: A Population-based Study

Overview

Journal J Diabetes

Specialty Endocrinology

Date 2023 Jun 17

PMID 37329140

Authors

Yong-Qi Liang

Rui Zhou

Hao-Wen Chen

Bi-Fei Cao

Wei-Dong Fan

Kuan Liu

Qi Zhong

Yi-Ning Huang

Xian-Bo Wu

Meng-Chen Zou

Affiliations

Soon will be listed here.

Abstract

Background: Arterial stiffness contributes to additional cardiovascular risks in diabetic patients by triggering the loss of vascular and myocardial compliance and promoting endothelial dysfunction. Thus, prevention of arterial stiffness is a public health priority, and the identification of potential biomarkers may provide benefits for early prevention. This study investigates the relationships between serum laboratory tests and pulse wave velocity (PWV) tests. We also investigated the associations between PWV and all-cause mortality.

Methods: We examined a panel of 33 blood biomarkers among diabetic populations in the Atherosclerosis Risk in Communities Study. The carotid-femoral (cfPWV) and femoral-ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The aortic-femoral arterial stiffness gradient (afSG) was calculated as faPWV divided by cfPWV. Biomarker levels were log-transformed and correlated with PWV. Cox proportional hazard models were employed for survival analysis.

Results: Among 1079 diabetic patients, biomarkers including high-density lipoprotein cholesterol, glycated hemoglobin, high-sensitivity troponin T, cystatin C, creatinine, and albuminuria were significantly correlated with afSG (R = 0.078, -0.193, -0.155, -0.153, -0.116, and -0.137, respectively) and cfPWV (R = -0.068, 0.175, 0.128, 0.066, 0.202, and 0.062, respectively). Compared with the lowest tertile of afSG, the risk of all-cause mortality was lower in the highest tertile (hazard ratio 0.543; 95% confidence interval 0.328-0.900).

Conclusion: Certain biomarkers related to blood glucose monitoring, myocardial injury, and renal function significantly correlated with PWV, suggesting that these putative risk factors are likely to be important atherosclerosis mechanisms in diabetic patients. AfSG may be an independent predictor of mortality among diabetic populations.

Citing Articles

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population-based study.

Liang Y, Zhou R, Chen H, Cao B, Fan W, Liu K J Diabetes. 2023; 15(10):853-865.

PMID: 37329140 PMC: 10590681. DOI: 10.1111/1753-0407.13433.

References

Liang J, Zhou N, Teng F, Zou C, Xue Y, Yang M . Hemoglobin A1c levels and aortic arterial stiffness: the Cardiometabolic Risk in Chinese (CRC) study. PLoS One. 2012; 7(8):e38485. PMC: 3411691. DOI: 10.1371/journal.pone.0038485. View

Assmann G, Gotto Jr A . HDL cholesterol and protective factors in atherosclerosis. Circulation. 2004; 109(23 Suppl 1):III8-14. DOI: 10.1161/01.CIR.0000131512.50667.46. View

Urbonaviciene G, Shi G, Urbonavicius S, Henneberg E, Lindholt J . Higher cystatin C level predicts long-term mortality in patients with peripheral arterial disease. Atherosclerosis. 2011; 216(2):440-5. PMC: 3110633. DOI: 10.1016/j.atherosclerosis.2011.02.016. View

Qu K, Yan F, Qin X, Zhang K, He W, Dong M . Mitochondrial dysfunction in vascular endothelial cells and its role in atherosclerosis. Front Physiol. 2023; 13:1084604. PMC: 9807884. DOI: 10.3389/fphys.2022.1084604. View

Wei G, Coady S, Goff Jr D, Brancati F, Levy D, Selvin E . Blood pressure and the risk of developing diabetes in african americans and whites: ARIC, CARDIA, and the framingham heart study. Diabetes Care. 2011; 34(4):873-9. PMC: 3064044. DOI: 10.2337/dc10-1786. View

Cruickshank K, Riste L, Anderson S, Wright J, Dunn G, Gosling R . Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function?. Circulation. 2002; 106(16):2085-90. DOI: 10.1161/01.cir.0000033824.02722.f7. View

Katakami N . Mechanism of Development of Atherosclerosis and Cardiovascular Disease in Diabetes Mellitus. J Atheroscler Thromb. 2017; 25(1):27-39. PMC: 5770221. DOI: 10.5551/jat.RV17014. View

Aronson D . Cross-linking of glycated collagen in the pathogenesis of arterial and myocardial stiffening of aging and diabetes. J Hypertens. 2003; 21(1):3-12. DOI: 10.1097/00004872-200301000-00002. View

Zieman S, Melenovsky V, Kass D . Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol. 2005; 25(5):932-43. DOI: 10.1161/01.ATV.0000160548.78317.29. View

10.

. The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators. Am J Epidemiol. 1989; 129(4):687-702. View

11.

Berard E, Bongard V, Ruidavets J, Amar J, Ferrieres J . Pulse wave velocity, pulse pressure and number of carotid or femoral plaques improve prediction of cardiovascular death in a population at low risk. J Hum Hypertens. 2013; 27(9):529-34. DOI: 10.1038/jhh.2013.8. View

12.

Fortier C, Mac-Way F, Desmeules S, Marquis K, De Serres S, Lebel M . Aortic-brachial stiffness mismatch and mortality in dialysis population. Hypertension. 2014; 65(2):378-84. DOI: 10.1161/HYPERTENSIONAHA.114.04587. View

13.

Elias M, Davey A, Dore G, Gillespie A, Abhayaratna W, Robbins M . Deterioration in renal function is associated with increased arterial stiffness. Am J Hypertens. 2013; 27(2):207-14. PMC: 3870855. DOI: 10.1093/ajh/hpt179. View

14.

Bai Y, Ye P, Luo L, Xiao W, Xu R, Wu H . Arterial stiffness is associated with minimally elevated high-sensitivity cardiac, troponin T levels in a community-dwelling population. Atherosclerosis. 2011; 218(2):493-8. DOI: 10.1016/j.atherosclerosis.2011.06.035. View

15.

Abulnaja K, Kannan K, Al-Manzlawi A, Kumosani T, Qari M, Moselhy S . Sensitivity, specificity of biochemical markers for early prediction of endothelial dysfunction in atherosclerotic obese subjects. Afr Health Sci. 2022; 22(2):286-294. PMC: 9652627. DOI: 10.4314/ahs.v22i2.32. View

16.

Helleputte S, Calders P, Rodenbach A, Marlier J, Verroken C, De Backer T . Time-varying parameters of glycemic control and glycation in relation to arterial stiffness in patients with type 1 diabetes. Cardiovasc Diabetol. 2022; 21(1):277. PMC: 9737749. DOI: 10.1186/s12933-022-01717-z. View

17.

Stone K, Fryer S, Faulkner J, Meyer M, Heffernan K, Kucharska-Newton A . The aortic-femoral arterial stiffness gradient is blood pressure independent in older adults: the atherosclerosis risk in communities (ARIC) study. J Hypertens. 2021; 39(12):2361-2369. PMC: 8570989. DOI: 10.1097/HJH.0000000000002937. View

18.

Wang J, Tan G, Han L, Bai Y, He M, Liu H . Novel biomarkers for cardiovascular risk prediction. J Geriatr Cardiol. 2017; 14(2):135-150. PMC: 5409355. DOI: 10.11909/j.issn.1671-5411.2017.02.008. View

19.

Martagon A, Fermin-Martinez C, Antonio-Villa N, Mehta R, Almeda-Valdes P, Vargas-Vazquez A . Arterial Stiffness and HbA1c: Association Mediated by Insulin Resistance in Hispanic Adults. Int J Environ Res Public Health. 2022; 19(17). PMC: 9518482. DOI: 10.3390/ijerph191711017. View

20.

Mahdavi-Roshan M, Mozafarihashjin M, Shoaibinobarian N, Ghorbani Z, Salari A, Savarrakhsh A . Evaluating the use of novel atherogenicity indices and insulin resistance surrogate markers in predicting the risk of coronary artery disease: a case‒control investigation with comparison to traditional biomarkers. Lipids Health Dis. 2022; 21(1):126. PMC: 9701407. DOI: 10.1186/s12944-022-01732-9. View