Abstract 17511: Aortic Stiffness Among Mexican-American Adults With Diabetes and Prediabetes: Evidence of Accelerated Vascular Aging and Increased Cardiac Biomarkers

Abstract

Introduction: Type 2 diabetes mellitus is associated with increased aortic stiffness, a finding that predicts adverse cardiovascular events. Whether individuals with dysglycemia below the diagnostic threshold for diabetes have increased aortic stiffness has been less studied, particularly in Hispanic adults, a population sharing a disproportionate burden of dysglycemia. Hypothesis: We hypothesized that individuals with prediabetes would: (1) have increased aortic stiffness compared to normal glycemia, and (2) increased aortic stiffness would be associated with biomarkers of myocardial injury. Aims: We aimed to: (1) identify the relationship between aortic stiffness and glycemic status in a Hispanic cohort, and (2) determine the relationship between cardiac biomarkers and aortic stiffness. Methods: We prospectively measured carotid-femoral pulse wave velocity (PWV) and glycemic measures in 728 Mexican American adults in Starr County, Texas. Cardiovascular biomarkers [high-sensitivity troponin T (hs-TnT), galectin-3, and NT-proBNP] were measured in a subset (n=404). Multivariable models (using natural log PWV) were used to adjust for confounders. Results: 45% of participants had diabetes, and 28% had prediabetes. PWV increased across glycemic categories; median PWV (25 th , 75 th ) in diabetes was 11.7 m/sec (9.9, 13.7), prediabetes 9.9 m/sec (8.6, 11.1), and normal glycemia 8.7 m/sec (7.9, 9.9) (adjusted p-value <0.001 and 0.008, respectively). The figure demonstrates PWV stratified by age decade; PWV in prediabetes was similar to PWV in those without diabetes who were a decade younger. Median levels of hs-TnT, galectin-3, and NT-proBNP increased across quartiles of PWV (p trend <0.001 for all). Conclusion: In a cohort of Hispanic adults, increased aortic stiffness develops before the onset of diabetes and seen in those with pre-diabetes. Importantly, increased aortic stiffness is associated with biomarkers of cardiac injury.