Abstract P336: Diabetes and Impaired Fasting Glucose are Associated with Pulse Wave Velocity in Older Adults: the ARIC Study

Abstract

Introduction: Arterial stiffness measured by pulse wave velocity (PWV) predicts cardiovascular disease and mortality. Diabetes and impaired fasting glucose (IFG) have been related to arterial stiffness in smaller studies. We assessed whether diabetes and impaired fasting glucose are associated with greater arterial stiffness measured by PWV in older adults, and to evaluate gender as a modifier. Methods: PWV data on 5,147 men and women with mean age of 75.5 years (range 66-90) examined in 2011-2013 by the Atherosclerosis Risk in Communities (ARIC) study were analyzed. Diabetes was defined as fasting glucose >126 mg/dl or on hypoglycemic agents and IFG as non-diabetics with fasting glucose 100-125 mg/dl. Technicians measured carotid-femoral (cfPWV) and brachial-ankle (baPWV) velocities at least twice using the Omron VP-1000 plus system (Colin Co., Ltd., Komaki, Japan). The mean of the last two available measurements was used. The path length for cfPWV was calculated by: path length (cm) = carotid to femoral distance (cm) - (suprasternal notch - carotid distance (cm)). Path length for baPWV was automatically calculated using height-based formulas. Multivariable linear regression was used to model the cross-sectional association between diabetes status and PWV. The multivariable association of age categories with PWV was evaluated for comparison to the effect size of diabetes. Results: Participants were 57% female, 20% African-American, and 73% hypertensive. Among them 1,354 had diabetes (26%) and 2,295 (45%) had impaired fasting glucose. After adjustment for age, race-center, gender, heart rate, hypertension, BMI, and smoking status (current, former and never), cfPWV was 87 cm/s higher on average for those with diabetes, and 21 cm/s higher for those with IFG, as compared to those free of diabetes or IFG. In comparison, a 4 year increase in age (after multivariable adjustment) was associated with 64 cm/s higher cfPWV among non-smokers without diabetes. Estimates for baPWV were smaller than those for cfPWV but showed a similar pattern. There was no significant interaction by gender (P >0.1). Conclusion: Diabetes and impaired fasting glucose are both associated with arterial stiffness in older adults. We estimate that the magnitude of the cross-sectional effect of diabetes on arterial stiffness is equivalent to 4 years of arterial aging.