Cardio-ankle vascular index in persons with prediabetes and diabetes mellitus in a population sample of Western Siberia of the Russian Federation

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases” The aim of this study was to evaluate the level of cardio-ankle vascular index (CAVI) in the presence of pre-diabetes and diabetes mellitus in the population sample of the Russian Federation, as well as to investigate the factors associated with pathological CAVI in these subjects. Methods 1628 (age 25-64 years) were recruited in a observational cross-sectional study ESSE-RF in the period from 2012 to 2013. The standard protocol of the ESSE-RF has been extended with additional study of CAVI. The final sample included 1617 people, they are divided into 3 groups: group 1 - patients with type 2 diabetes mellitus (n = 272), group 2 - patients with prediabetes - IFG, IGT or their combination (n = 44), and group 3 - persons without CMD (n = 1301). Results The median CAVI was higher in diabetes and pre-diabetes groups (p = 0.009 and p <0.001, respectively, compared with group without CMD). Pathological CAVI (≥9.0) was detected in 16.8% of diabetes patients, in 15.9% of those with prediabetes, and in 9.0% of those without CMD (p <0.001 when comparing diabetes group and group without CMD). The groups with diabetes and prediabetes also did not differ in factors affecting the level of arterial wall stiffness (gender, blood pressure, age, dyslipidemia, uric acid level). According to the result of the correlation analysis in the general sample, CAVI positively correlated with age (p <0.001), male sex (p <0.001), type 2 diabetes (p <0.001), prediabetes (p = 0.002), waist circumference (p <0.001), visceral obesity (p <0.001), total cholesterol (p <0.001), triglycerides (p <0.001), LDL cholesterol (p <0.001), and with the inverse correlation - with glomerular filtration rate (GFR, p <0.001). In multivariate analysis, age and the presence of arterial hypertension were independently associated with pathological CAVI in the groups of patients with CMD, and in the group without CMD, in addition to these factors - a decrease in GFR. Conclusions In the population sample of the Russian Federation, the CAVI index values in the prediabetes and diabetes patients were higher than in the normoglycemia persons. The groups with diabetes and prediabetes also did not differ in factors affecting the level of arterial wall stiffness. Since the identified disorders of arterial stiffness in prediabetes are similar to those in diabetes, their identification is important to prevent further cardiovascular complications.