Cardiometabolic Risk Factors, Peripheral Arterial Tonometry and Metformin in Adults with Type 1 Diabetes Participating in the REducing with MetfOrmin Vascular Adverse Lesions Trial

Overview

Journal Diab Vasc Dis Res

Publisher Sage Publications

Specialty Cardiology & Vascular Diseases

Date 2023 Jun 30

PMID 37387358

Authors

David Chen

Alicia J Jenkins

Nicola Greenlaw

Katie Dudman

Tamsin Fernandes

David M Carty

Alun D Hughes

Andrzej S Januszewski

Coen DA Stehouwer

John R Petrie

Affiliations

Soon will be listed here.

Abstract

Background: Peripheral arterial tonometry (PAT) provides non-invasive measures of vascular health. Beneficial effects of metformin on vascular function have been reported in youth with type 1 diabetes (T1D). In the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial in adults with T1D and high cardiovascular risk, we examined: (i) the extent to which routinely-measured cardiometabolic risk factors explain variance in baseline PAT; and (ii) the effects of metformin on PAT measures.

Methods: Cross-sectional univariable and multivariable analyses of baseline reactive hyperaemia index (RHI) and augmentation index (AI) (EndoPAT® (Itamar, Israel); and analysis of 36-months metformin versus placebo on vascular tonometry.

Results: In 364 adults ((mean ± SD) age 55.2 ± 8.5 years, T1D 34.0 ± 10.6 years, HbA1c 64.5 ± 9.0 mmol/mol (8.1 ± 0.8%)), RHI was 2.26 ± 0.74 and AI was 15.9 ± 19.2%. In an exhaustive search, independent associates of (i) RHI were smoking, waist circumference, systolic blood pressure and vitamin B12 (adjusted = 0.11) and (ii) AI were male sex, pulse pressure, heart rate and waist circumference (adjusted = 0.31). Metformin did not significantly affect RHI or AI.

Conclusion: Cardiometabolic risk factors explained only a modest proportion of variance in PAT measures of vascular health in adults with T1D and high cardiovascular risk. PAT measures were not affected by metformin.

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