PMID- 27035734
OWN - NLM
STAT- MEDLINE
DCOM- 20170802
LR  - 20220317
IS  - 1473-5598 (Electronic)
IS  - 0263-6352 (Linking)
VI  - 34
IP  - 6
DP  - 2016 Jun
TI  - Aortic-to-brachial stiffness gradient and kidney function in type 2 diabetes.
PG  - 1132-9
LID - 10.1097/HJH.0000000000000916 [doi]
AB  - OBJECTIVES: A reversed aortic-to-brachial stiffness gradient (ab-SG), defined as 
      aortic pulse wave velocity (aPWV) greater than brachial PWV (bPWV), was recently 
      shown to predict mortality independent of aPWV in dialysis patients. Patients 
      with type 2 diabetes mellitus (T2DM) have increased risk of renal damage and 
      exhibit haemodynamic abnormalities at rest and during exercise that may alter the 
      ab-SG. This study aimed to examine ab-SG in patients with T2DM by comparison with 
      nondiabetic controls during rest and exercise, and to determine associations 
      between ab-SG, aPWV, and kidney function. METHODS: Study participants were 60 
      patients with T2DM and 60 age and sex-matched nondiabetic controls (58 +/- 8 years, 
      55% male both). ab-SG was defined as the quotient of bPWV (carotid-to-radial) and 
      aPWV (carotid-to-femoral) recorded via applanation tonometry. Kidney function was 
      assessed using estimated glomerular filtration rate (eGFR). The exercise substudy 
      was undertaken in 21 patients with T2DM and 21 matched nondiabetic controls 
      during semirecumbent exercise. RESULTS: ab-SG was significantly lower in patients 
      with T2DM (0.99 +/- 0.2 vs. 1.2 +/- 0.3, P < 0.001) and aPWV, but not bPWV, was 
      significantly higher (P < 0.001 and P = 0.25). A total of 58% of patients with 
      T2DM vs. 27% of nondiabetic controls (chi = 11.0, P < 0.001) had a reversed ab-SG 
      (aPWV >/= bPWV). ab-SG predicted eGFR independent of age, sex, T2DM status, and 
      cardiovascular risk factors (beta = 13.2, P = 0.024), whereas aPWV did not 
      (beta = -0.88, P = 0.30). Exercise ab-SG was significantly lower in patients with 
      T2DM (0.97 +/- 0.2 vs. 1.2 +/- 0.2, P < 0.001), but did not predict eGFR. 
      CONCLUSIONS: Patients with T2DM have a reversed ab-SG during rest and exercise. 
      Resting ab-SG predicts kidney function independent of aPWV, implying a reversed 
      ab-SG may have a pathophysiological function.
FAU - Picone, Dean S
AU  - Picone DS
AD  - aMenzies Institute for Medical Research, University of Tasmania, Hobart bStroke 
      and Ageing Research Centre, Department of Medicine, School of Clinical Sciences 
      at Monash Health, Monash University, Melbourne, Australia.
FAU - Schultz, Martin G
AU  - Schultz MG
FAU - Climie, Rachel E D
AU  - Climie RE
FAU - Srikanth, Velandai
AU  - Srikanth V
FAU - Sharman, James E
AU  - Sharman JE
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - J Hypertens
JT  - Journal of hypertension
JID - 8306882
SB  - IM
MH  - Aged
MH  - Carotid Arteries/physiopathology
MH  - Case-Control Studies
MH  - Diabetes Mellitus, Type 2/*physiopathology
MH  - Exercise/physiology
MH  - Female
MH  - Femoral Artery/physiopathology
MH  - Glomerular Filtration Rate
MH  - Hemodynamics
MH  - Humans
MH  - Kidney/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Pulse Wave Analysis
MH  - Radial Artery/physiopathology
MH  - Rest/physiology
MH  - *Vascular Stiffness
EDAT- 2016/04/02 06:00
MHDA- 2017/08/03 06:00
CRDT- 2016/04/02 06:00
PHST- 2016/04/02 06:00 [entrez]
PHST- 2016/04/02 06:00 [pubmed]
PHST- 2017/08/03 06:00 [medline]
AID - 10.1097/HJH.0000000000000916 [doi]
PST - ppublish
SO  - J Hypertens. 2016 Jun;34(6):1132-9. doi: 10.1097/HJH.0000000000000916.