18-OR: Longitudinal Changes in Vascular Stiffness and Heart Rate Variability (HRV) in Young Adults with Type 2 Diabetes (T2D): The TODAY Study

Abstract

Little is known about how arterial stiffness and HRV progress in young adults with youth-onset T2D. We examined changes in pulse wave velocity (PWV), augmentation index (AIx), brachial distensibility and HRV over 5-years in young adults with T2D (n=304, 34% male, first assessment at mean age 21 years, mean diabetes duration 8 years) who participated in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) trial. Changes by sex, race/ethnicity, and the risk factors associated with the changes in arterial stiffness and HRV were assessed. PWV carotid-femoral, AIx and HRV worsened over 5-years (p<0.0001), Table. There were no differences in the 5-year change by race/ethnicity. In multivariable models, female sex (β=2.9, p=0.03) and mean arterial pressure (β=1.9 per 10 mmHg, p< 0.001) related to greater worsening in AIx. Mean arterial pressure related to PWV carotid-femoral (β=0.4 per 10 mmHg, p<0.0001). Higher time-weighted mean HbA1c, a measure of cumulative glycemic exposure, was related to worsening of both PWV carotid-femoral and HRV (β=0.1, p=0.03 and β=-3.8, p<0.0001, per 1% respectively). Targeting improvements in blood pressure and glycemic control may favorably influence the progression of arterial stiffness and HRV in T2D.View largeDownload slideView largeDownload slide DisclosureA. S. Shah: None. S. A. Arslanian: Advisory Panel; Self; Eli Lilly and Company, Novo Nordisk, Other Relationship; Self; AstraZeneca, Research Support; Self; Eli Lilly and Company, Novo Nordisk. E. M. Urbina: None. L. El ghormli: None. S. Gidding: None. K. S. Hughan: None. L. E. Katz: None. D. Koren: None. J. B. Tryggestad: None. F. Bacha: None. B. H. Braffett: None.FundingNational Institute of Diabetes and Digestive and Kidney Diseases (U01DK61212, U01DK61230, U01DK61239, U01DK61242, U01DK61254)