Association of Elevated Arterial Stiffness with Cardiac Target Organ Damage and Cardiac Autonomic Neuropathy in Young Adults with Diabetes: The SEARCH for Diabetes in Youth Study

Abstract

<p> </p> <p><em>Background:</em> Adults with diabetes are at risk of cardiovascular (CV) events, possibly due to increased arterial stiffness (AS) and cardiac autonomic neuropathy (CAN). We sought to determine if 1) AS is associated with cardiac target organ damage in young adults with youth-onset diabetes, 2) whether CAN is associated with AS, as one possible etiology for increased AS in this cohort, and 3) whether these relationships differed by type of diabetes. </p> <p><em>Methods:</em> Participants from the SEARCH for Diabetes in Youth Study (type 1 diabetes mellitus, T1D = 222, type 2 diabetes mellitus, T2D = 177, mean 23 years) had clinical, echocardiographic, AS and CAN assessed. Linear regression was performed to determine if AS was associated with cardiac changes and CAN and if relationships differed by diabetes type. </p> <p><em>Results:</em> AS was significantly associated with cardiac structure (left ventricular mass index, p<0.0001), systolic function (ejection fraction, p=0.03) and diastolic function (E/A ratio, p=0.008; e’/a’, p=0.02) after adjustments for CV risk factors. The association between AS and CAN was not significant when other important covariates were added. These relationships were mostly similar in both T1D and T2D. </p> <p><em>Conclusions:</em> AS is associated with cardiac changes in young adults with diabetes. CAN-induced AS does not appear to be an etiology for cardiac abnormalities in this cohort. </p>