Background
Methods
Study population
Study protocol
Vascular examination
Cardiac ultrasound
Medical history and physical examination
Analytical procedures
Statistical analysis
Results
Characteristics of the study populations
T2DM patients | Healthy volunteers |
P
| |
---|---|---|---|
Mean ± SD/median [IQR] | Mean ± SD/median [IQR] | ||
Gender (M:F) | 82:43 | 61:40 | 0.45 |
Age (years) | 58 ± 7 | 57 ± 8 | 0.24 |
Height (cm) | 170 ± 9 | 171 ± 9 | 0.36 |
BMI (kg/m2) | 28.6 ± 4.2 | 26.1 ± 3.6 | <0.0001 |
Obesity (%) | 26.4 | 9.0 | 0.0001 |
Waist circumference (cm) | 104 ± 11 | 93 ± 10 | <0.0001 |
Heart rate (bpm) | 68 ± 11 | 62 ± 10 | <0.0001 |
Systolic/diastolic BP (mmHg) | 138 ± 17/80±9 | 121 ± 11/75±7 | <0.0001 |
LDL-cholesterol (mmol/L) | 2.89 ± 0.72 | 3.11 ± 0.93 | 0.10 |
HDL-cholesterol (mmol/L) | 1.28 ± 0.31 | 1.48 ± 0.34 | <0.0005 |
Triglycerides (mmol/L) | 1.33 [0.94] | 1.11 [0.73] | 0.001 |
Fasting glucose (mmol/L) | 7.0 ± 1.8 | 5.1 ± 0.5 | <0.0001 |
HbAc1 (%) | 7.0 [1.3] | ||
T2DM duration (years) | 7.1 ± 6.4 | ||
Current smoking (%) | 35.2 | 29.1 | 0.26 |
BP-lowering treatment (%) | 52.8 | 0 | <0.0001 |
Lipid-lowering treatment (%) | 44.0 | 0 | <0.0001 |
T2DM patients | Healthy volunteers |
P
| |
---|---|---|---|
Mean ± SD | Mean ± SD | ||
LV mass (g) | 207 ± 41 | 176 ± 42 | <0.005 |
LV mass index (g/m2.7) | 50 ± 11 | 41 ± 9 | <0.0001 |
LV hypertrophy (%) | 51.2 | 18.6 | <0.0001 |
Inappropriate LV mass (%) | 56.8 | 17.6 | <0.0001 |
Ejection fraction (%) | 65 ± 7 | 66 ± 8 | 0.29 |
ess-MWS (%) | 101 ± 15 | 108 ± 11 | <0.005 |
Stroke volume (mL) | 72 ± 17 | 76 ± 17 | 0.15 |
E/A ratio transmitral | 0.90 ± 0.24 | 1.10 ± 0.27 | <0.0001 |
E/e′ ratio | 7.4 ± 2.1 | 5.9 ± 1.4 | <0.0001 |
e′ velocity (cm/s) | 9.4 ± 1.7 | 11.5 ± 2.2 | <0.0001 |
s′ velocity (cm/s) | 9.1 ± 1.4 | 9.6 ± 1.4 | <0.05 |
cfPWV (m/s) | 8.5 ± 1.8 | 7.1 ± 1.3 | <0.0001 |
ccaPWV (m/s) | 8.4 ± 1.8 | 7.1 ± 1.6 | <0.0005 |
Carotid systolic BP (mmHg) | 124 ± 14 | 111 ± 11 | <0.0001 |
Carotid pulse pressure (mmHg) | 44 ± 13 | 35 ± 9 | <0.0001 |
Univariate correlations
T2DM patients | Healthy volunteers | |||||
---|---|---|---|---|---|---|
e′ (cm/s) | cfPWV (m/s) | LV mass (g) | e′ (cm/s) | cfPWV (m/s) | LV mass (g) | |
cfPWV (m/s) | −0.32 | – | 0.21 | −0.47 | – | 0.26 |
Carotid systolic BP (mmHg) | −0.38 | 0.44 | 0.22 | −0.58 | 0.46 | 0.36 |
Carotid pulse pressure (mmHg) | −0.31 | 0.26 | ns | −0.40 | 0.44 | 0.29 |
Age (years) | −0.31 | 0.29 | ns | −0.61 | 0.47 | 0.35 |
BMI (kg/m2) | ns | 0.21 | 0.25 | ns | ns | 0.37 |
Waist circumference (cm) | ns | 0.23 | 0.45 | −0.24 | 0.25 | 0.45 |
Heart rate (bpm) | −0.25 | 0.24 | 0.20 | ns | 0.22 | ns |
Stroke volume (mL) | 0.19 | ns | ns | ns | ns | 0.43 |
LV mass (g) | −0.31 | 0.21 | – | −0.32 | 0.26 | – |
Log triglycerides | ns | ns | ns | ns | ns | ns |
LDL-cholesterol (mmol/L) | ns | ns | ns | ns | ns | ns |
HDL-cholesterol (mmol/L) | ns | ns | ns | ns | ns | −0.27 |
Fasting glucose (mmol/L) | −0.23 | 0.18 | 0.24 | −0.29 | 0.32 | ns |
Log HbA1c | −0.27 | 0.37 | 0.39 | – | – | – |
T2DM duration (years) | ns | 0.21 | 0.34 | – | – | – |
Independent determinants of e′ velocity, cfPWV, LV mass and ccaPWV
T2DM patients | Healthy volunteers | |||||
---|---|---|---|---|---|---|
e′ velocity (cm/s) | cfPWV (m/s) | LV mass (g) | e′ velocity (cm/s) | cfPWV (m/s) | LV mass (g) | |
Sex (male) | 0.19 ± 0.08 | 0.18 ± 0.08 | ||||
Age (years) | −0.22 ± 0.08 | 0.22 ± 0.07 | −0.37 ± 0.08 | 0.34 ± 0.10 | 0.25 ± 0.08 | |
Height (cm) | 0.45 ± 0.07 | |||||
Waist circumference (cm) | 0.26 ± 0.07 | |||||
Carotid SBP (mmHg) | −0.25 ± 0.08 | 0.28 ± 0.07 | 0.18±0.07 | −0.24 ± 0.08 | 0.26 ± 0.09 | 0.28 ± 0.08 |
Heart rate (bpm) | −0.24 ± 0.08 | 0.18 ± 0.07 | 0.30 ± 0.08 | |||
Stroke volume (mL) | 0.25 ± 0.07 | |||||
LV mass (g) | −0.25 ± 0.09 | |||||
s′ velocity (cm/s) | 0.43 ± 0.06 | |||||
Fasting glucose (mmol/L) | 0.29 ± 0.08 | |||||
Log HbA1c | 0.25 ± 0.07 | 0.19 ± 0.08 | ||||
T2DM duration (years) | 0.22 ± 0.07 | |||||
Cumulative R2
| 0.32
P < 0.0001 | 0.34
P < 0.0001 | 0.38
P < 0.0001 | 0.60
P < 0.0001 | 0.43
P < 0.0001 | 0.56
P < 0.0001 |
Poor glycemic control and cardiovascular measures
HbA1c <6.5% | HbA1c ≥6.5% |
P
| |
---|---|---|---|
N | 40 | 85 | |
Age (years) | 58 ± 8 | 58 ± 10 | 0.74 |
Male:female | 25:15 | 60:25 | 0.37 |
T2DM duration (years) | 6.0 ± 5.2 | 7.6 ± 6.8 | 0.18 |
HbAc1 (%) | 6.1 ± 0.3 | 7.6 ± 0.9 | <0.0001 |
Carotid systolic BP (mmHg) | 119 ± 13 | 126 ± 14 | 0.01 |
cfPWV (m/s) | 8.0 ± 1.5 | 8.7 ± 1.9 | <0.05 |
Increased cfPWV (%) | 15.0 | 32.9 | <0.05 |
ccaPWV (m/s) | 8.3 ± 1.6 | 8.5 ± 1.8 | 0.31 |
LVMI (g/m2.7) | 46 ± 10 | 52 ± 10 | 0.005 |
LVH (%) | 35.0 | 58.8 | 0.01 |
e′ velocity (cm/s) | 10.1 ± 1.6 | 9.1 ± 1.7 | 0.001 |
Diastolic dysfunction (%) | 22.5 | 40.0 | <0.05 |
s′ velocity (cm/s) | 9.5 ± 1.5 | 8.9 ± 1.4 | <0.05 |
ess-MWS (%) | 105 ± 13 | 99 ± 16 | <0.05 |