Glycemic markers and relation with arterial stiffness in Caucasian subjects of the MARK study
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Effect of prediabetes and normal glucose on arterial stiffness remains controversial. The primary
aim of this study was to investigate the relationship of fasting plasma glucose (FPG),
postprandial glucose (PG) and glycosylated haemoglobin (HbA1c) with brachial-ankle pulse
wave velocity (baPWV) and cardio-ankle vascular index (CAVI) in Caucasian adults. The
secondary aim was to analyse this relationship by glycaemic status.
Methods
Cross-sectional study. Setting: Primary care. Participants: 2,233 subjects, 35±74 years.
Measures: FPG (mg/dL) and HbA1c (%) of all subjects were measured using standard automated
enzymatic methods. PG (mg/dL) was self-measured at home two hours after meals
(breakfast, lunch and dinner) for one day using an Accu-chek ® glucometer. CAVI was measured
using a VaSera VS-1500® device (Fukuda Denshi), and baPWV was calculated using
a validated equation.
Results
CAVI and baPWV values were significantly higher in subjects with diabetes mellitus than in
glucose normal and prediabetes groups (p<0.001). FPG, PG and HbA1c were positively
associated with CAVI and baPWV. The β regression coefficient for: HbA1c was 0.112 (CI 95% 0.068 to 0.155) with CAVI, 0.266 (CI 95% 0.172 to 0.359) with baPWV; for PG was
0.006 (CI 95% 0.004 to 0.009 and for FPG was 0.005 (CI 95% 0.002 to 0.008) with baPWV;
and for PG was 0.002 (CI 95% 0.001 to 0.003) and 0.003 (CI 95% 0.002 to 0.004) with CAVI
(p<0.01 in all cases). When analysing by hyperglycaemic status, FPG, PG and HbA1c were
positively associated with CAVI and baPWV in subjects with type 2 diabetes mellitus.
Conclusion
FPG, PG and HbA1c show a positive association with CAVI and baPWV, in Caucasian
adults with intermediate cardiovascular risk factors. When analysing by hyperglycaemic status,
the association is only maintained in subjects with type 2 diabetes mellitus