Associations Between Cardio-Ankle Vascular Index and Microvascular Complications in Type 2 Diabetes Mellitus Patients

• Published in: Journal of Atherosclerosis and Thrombosis Vol. 18; no. 4; pp. 328 - 336
• Main Authors: Kim, Kwang Joon, Lim, Sung-Kil, Lee, Hyun Chul, Lee, Byung-Wan, Kim, Hyun-min, Shin, Joo Youn, Lee, Eun Jig, Kang, Eun Seok, Cha, Bong Soo
• Format: Journal Article
• Language: English
• Published: Japan Japan Atherosclerosis Society 01.01.2011
• Subjects: Adult; Aged; Ankle Brachial Index - statistics & numerical data; Arterial stiffness; Cardio-ankle vascular index; Carotid Artery Diseases - pathology; Cross-Sectional Studies; Democratic People's Republic of Korea - epidemiology; Diabetes Mellitus, Type 2 - complications; Diabetic Angiopathies - pathology; Diabetic Nephropathies; Diabetic neuropathy; Humans; Microalbuminuria; Microcirculation; Middle Aged; Plaque, Atherosclerotic; Retrospective Studies; Tunica Intima - pathology; Type 2 diabetes mellitus; Vascular Diseases - diagnosis; Vascular Diseases - etiology; Vascular Diseases - pathology; Democratic People's Republic of Korea
• ISSN: 1340-3478; 1880-3873; 1880-3873
• DOI: 10.5551/jat.5983

Aim: Type 2 diabetes mellitus (T2DM) is a risk factor for increased arterial stiffness. We evaluated associations between the cardio-ankle vascular index (CAVI) and carotid plaque, intima media thickness (IMT), and diabetic microvascular complications in Korean T2DM patients. Methods: We conducted a retrospective, cross-sectional study of 320 Korean T2DM patients without a history of macrovascular disease or macroalbuminuria. We measured 24-hour urinary albumin excretion (UAE) levels and performed funduscopic and neuropathy examinations to assess the extent of diabetic microvascular complications. Arterial stiffness was assessed using CAVI. We also measured the ankle-brachial index (ABI), common carotid artery IMT, and carotid beta stiffness index. Results: Among the 320 patients enrolled in this study, 64 (20%) had increased CAVI (≥ 9). We found that CAVI was correlated with systolic blood pressure, pulse pressure, IMT, carotid beta stiffness index, log-transformed UAE, and total cholesterol. In multiple logistic regression analysis, mean IMT and the presence of carotid plaque were independently associated with increased CAVI (≥ 9) (OR=5.77, P < 0.01; OR=5.36, P < 0.001, respectively). Furthermore, an increased CAVI was associated with peripheral neuropathy (OR=2.03, P = 0.03) and microalbuminuria (OR=2.47, P < 0.01) after adjusting for possible confounding variables. Conclusions: The results of this study suggest that increased CAVI is associated with the presence of arterial plaque, increased IMT, and microvascular complications, such as nephropathy and neuropathy, in T2DM patients.