Increased arterial stiffness is closely associated with hyperglycemia and improved by glycemic control in diabetic patients.

Abstract

Although arteriosclerotic diseases have been reported to be frequently complicated by diabetes mellitus (DM), a detailed relationship between hyperglycemia and arterial stiffness has not been fully clarified. We investigated the influence of hyperglycemia on arterial stiffness using the cardio-ankle vascular index (CAVI), which is a new method for estimating arterial stiffness. CAVI values of 52 early-staged DM patients (duration <5years, no microangiopathies) were compared with those of 43 age-matched non-diabetic (NDM) subjects. The association between CAVI and clinical background factors was evaluated. The effect of glycemic improvement on CAVI was examined in 36 DM patients who were hospitalized for 2weeks to treat hyperglycemia. CAVI and clinical parameters were measured twice during hospitalization and again after 8weeks. Additionally, we measured CAVI before and 2h after breakfast in five DM and five NDM subjects. The CAVI of DM patients was significantly higher than that of NDM subjects. Multiple regression analysis showed that neither hypertension, obesity nor dyslipidemia, but aging and hemoglobin A1c (HbA1c) were significantly related to CAVI elevation. The CAVI, HbA1c and total cholesterol (TC) had significantly improved. Improvement of CAVI was significantly associated with HbA1c improvement. In contrast, no significant association was observed between the improvements of TC and CAVI. CAVI values before and after breakfast did not change significantly. CAVI elevation seems to be a sensitive arteriosclerotic marker, which is closely associated with hyperglycemia and improved by glycemic control.