Abstract
Aim. We investigated the relationship between brachial-ankle pulse wave velocity (baPWV) and glucose levels, insulin sensitivity, and beta-cell function in Chinese individuals with or without hypertension. Methods. We recruited 3137 nondiabetic individuals whose age, body mass index (BMI), glucose levels, blood pressure (BP), lipids, hemoglobin A1C (HbA1c), baPWV, and insulin levels were measured. Results. In normotensive group, 2 h glucose levels (β = 0.046, P < 0.001) associated with baPWV, showed a significant increase in patients with NG as compared to those with DM (P = 0.032). The hypertensive group showed no such differences. The Matsuda index (β = 0.114, P < 0.001) and HOMA-β (β = 0.045, P < 0.001) were negatively correlated with baPWV while lnHOMA-IR (β = 0.196, P = 0.076) and the Quantitative Insulin Sensitivity Check Index (QUICKI) (β = 0.226, P = 0.046) showed a borderline negative correlation. BaPWV significantly decreased (P = 0.032) with an increase in insulin sensitivity in individuals with both normal BP and glucose tolerance. Conclusions. BaPWV was significantly associated with 2 h glucose levels, insulin sensitivity and beta-cell function in normotensive population, whereas in hypertensive individuals, BP was the dominant factor influencing arterial stiffness. Individuals with abnormal insulin sensitivity in the absence of diabetes and hypertension are also at an increased risk of arterial stiffness.
Highlights
It is well known that the prevalence of cardiovascular disease (CVD) is high among individuals with abnormal glucose tolerance, resulting in significant mortality and morbidity rates from macrovascular diseases in such individuals
Recent studies have suggested that 1 h or 30 min blood glucose levels during the oral glucose tolerance test (OGTT) may demonstrate a stronger correlation with arterial stiffness [9,10,11]
With regard to the normotensive individuals, after adjustment for age, gender, body mass index (BMI), lipids levels, heart rate (HR), systolic BP (SBP), diastolic BP (DBP) and working heart rate (WHR), Figure 1(a) shows that the pre-DM group had a higher brachial-ankle pulse wave velocity (baPWV) compared with the NGT group (P = 0.005), while the DM group had the highest baPWV among the three groups (NGT versus DM, P < 0.001; pre-DM versus DM, P = 0.019)
Summary
It is well known that the prevalence of cardiovascular disease (CVD) is high among individuals with abnormal glucose tolerance, resulting in significant mortality and morbidity rates from macrovascular diseases in such individuals. A large number of population studies have focused on the relationship between arterial stiffness and glucose abnormality; the conclusions remain controversial. Among these studies, most have revealed a positive association between arterial stiffness and type 2 diabetes [1,2,3,4], while some have found fasting and postchallenge glucose levels and HbA1c levels, which reflect 2-3 months of glycemic control, to be independently related to accelerated stiffening of arteries [4,5,6]. We investigated the relationship between baPWV and glucose metabolism in a large sample of Chinese individuals with or without hypertension and delineated the impact of different glucose metabolism conditions on baPWV as well as the impact of the interaction between glucose levels and BP on arterial stiffness
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