Metabolic parameters associated with arterial stiffness in older adults with Type 2 diabetes

OBJECTIVE: Increased arterial stiffness, as measured by pulse wave velocity (PWV), is associated with increased cardiovascular risk in the general population. Few studies have examined factors associated with increased PWV in people with Type 2 diabetes. The aim of this study was to determine whether there was a link between PWV and clinical variables associated with central obesity, in men and women with Type 2 diabetes. RESEARCH DESIGNS AND METHODS: Eight hundred and sixty individuals [mean age (±SD) 69 (±4) years] from the Edinburgh Type 2 Diabetes Study, underwent applanation tonometry using a high-fidelity micromanometer. PWV was measured by sequentially recording electrocardiogram-gated carotid and femoral artery waveforms. RESULTS: Waist circumference (β = 0.10, P < 0.01) and waist : hip ratio (β = 0.10, P < 0.01) were independently associated with PWV, but not with BMI. In a stepwise multiple regression model, mean arterial pressure (β = 0.26, P < 0.01) and age (β = 0.23, P < 0.01) were strongly associated with PWV. The associations between the central obesity measures and PWV were independent of age, sex, duration of diabetes and metabolic factors associated with central obesity. Duration of diabetes (β = 0.10, P < 0.01) and glycated hemoglobin (β = 0.09, P < 0.01) were also found to be independent predictors of arterial stiffness. Obesity biomarkers such as C-reactive protein, leptin, tumour necrosis factor-α and interleukin-6 were not associated with arterial stiffness. CONCLUSION: Central obesity in people with Type 2 diabetes was associated with increased arterial stiffness. This association was independent of the conventional factors associated with central obesity and further studies are required to identify the mechanisms involved.