Fasting Glucose, Glycated Hemoglobin, and 2h Post-load Blood Glucose Are Independently Associated With Arterial Stiffness in Diabetes: The ELSA-Brasil Study

• Published in: Angiology Vol. 75; no. 7; pp. 635 - 644
• Main Authors: Pereira, Wille D. S., Lelis, Deborah F., Cunha, Roberto S., Griep, Rosane H., Barreto, Sandhi M., Molina, Maria del Carmen B., Schmidt, Maria Inês, Duncan, Bruce B., Bensenor, Isabela, Lotufo, Paulo A., Mill, José Geraldo, Baldo, Marcelo P.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-08-2024
• Subjects: Adult; Aged; Biomarkers - blood; Blood Glucose - analysis; Blood Glucose - metabolism; Brazil - epidemiology; Carotid-Femoral Pulse Wave Velocity; Cross-Sectional Studies; Diabetes Mellitus - blood; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - physiopathology; Fasting - blood; Female; Glucose Tolerance Test; Glycated Hemoglobin - analysis; Glycated Hemoglobin - metabolism; Humans; Male; Middle Aged; Prevalence; Pulse Wave Analysis; Risk Factors; Vascular Stiffness; Brazil; arterial stiffness; 2h post-load blood glucose; fasting glucose; diabetes; HbA1c
• ISSN: 0003-3197; 1940-1574; 1940-1574
• DOI: 10.1177/00033197231166180

The association of diabetes with increased large artery stiffness is not definitively established. We aimed to describe the carotid-femoral pulse wave velocity (cf-PWV) in participants with and without diabetes and whether the cf-PWV could vary among the different laboratory-based criteria used. A cross-sectional analysis using baseline data from 13,912 adults was used. cf-PWV as well as anthropometric, biochemical, and clinical data were measured. Diabetes was defined by previous medical diagnosis, medication use, fasting glucose, an oral glucose tolerance test (GTT), or glycated hemoglobin (HbA1c). The prevalence of diabetes was 18.7%, higher in men than in women. After adjustment, participants with diabetes showed higher cf-PWV (men: 9.7 ± 1.7 vs 9.4 ± 1.7 m/s, P < .05; women: 9.4 ± 1.6 vs 9.1 ± 1.7 m/s, P < .05). We observed a progressive increase in cf-PWV as >1 laboratory-based criterion for diabetes diagnosis was reached. Also, participants with diabetes with alterations in any laboratory-based criteria had higher cf-PWV than participants without diabetes, regardless of sex. In summary, diabetes is associated with higher cf-PWV as is each laboratory-based parameter used for its diagnosis. These results support the strong consequences of glucose dysregulation on the vascular system and provide evidence to screen all parameters involved in glycemic metabolism to improve vascular health.