Arterial Stiffness Is Increased in Patients With Type 1 Diabetes Without Cardiovascular Disease: A potential role of low-grade inflammation

• Published in: Diabetes care Vol. 35; no. 5; pp. 1083 - 1089
• Main Authors: Llauradó, Gemma, Ceperuelo-Mallafré, Victòria, Vilardell, Carme, Simó, Rafael, Freixenet, Núria, Vendrell, Joan, González-Clemente, José Miguel
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.05.2012
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Blood pressure; blood serum; body mass index; C-reactive protein; C-Reactive Protein - metabolism; Cardiovascular disease; Cardiovascular Diseases; Care and treatment; Cholesterol; correlation; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - immunology; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetics; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Hypertension; Inflammation; Inflammation - blood; Inflammation - physiopathology; insulin-dependent diabetes mellitus; interleukin-6; Interleukin-6 - blood; linear models; Male; Medical research; Medical sciences; Medicine, Experimental; men; Metabolic diseases; Middle Aged; Miscellaneous; necrosis; Original Research; patients; Public health. Hygiene; Public health. Hygiene-occupational medicine; receptors; regression analysis; risk factors; Sex Factors; Tumor necrosis factor; tumor necrosis factor-alpha; Type 1 diabetes; Vascular Stiffness - physiology; women; Young Adult; Spain; Endocrinopathy; Human; Immunopathology; Nutrition; Patient; Autoimmune disease; Metabolic diseases; Cardiovascular disease; Inflammation; Vascular disease; Type 1 diabetes; Atherosclerosis; Stiffness; Endocrinology
• DOI: 10.2337/dc11-1475
• ISSN: 0149-5992

OBJECTIVE: To investigate the relationship between arterial stiffness and low-grade inflammation in subjects with type 1 diabetes without clinical cardiovascular disease. RESEARCH DESIGN AND METHODS: Sixty-eight patients with type 1 diabetes and 68 age- and sex-matched healthy subjects were evaluated. Arterial stiffness was assessed by aortic pulse wave velocity (aPWV). Serum concentrations of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, and soluble fractions of tumor necrosis factor-α receptors 1 and 2 (sTNFαR1 and sTNFαR2, respectively) were measured. All statistical analyses were stratified by sex. RESULTS: Subjects with diabetes had a higher aPWV compared with healthy control subjects (men: 6.9 vs. 6.3 m/s, P < 0.001; women: 6.4 vs. 6.0 m/s, P = 0.023). These differences remained significant after adjusting for cardiovascular risk factors. Men with diabetes had higher concentrations of hsCRP (1.2 vs. 0.6 mg/L; P = 0.036), IL-6 (0.6 vs. 0.3 pg/mL; P = 0.002), sTNFαR1 (2,739 vs. 1,410 pg/mL; P < 0.001), and sTNFαR2 (2,774 vs. 2,060 pg/mL; P < 0.001). Women with diabetes only had higher concentrations of IL-6 (0.6 vs. 0.4 pg/mL; P = 0.039). In men with diabetes, aPWV correlated positively with hsCRP (r = 0.389; P = 0.031) and IL-6 (r = 0.447; P = 0.008), whereas in women with diabetes no significant correlation was found. In men, multiple linear regression analysis showed that the following variables were associated independently with aPWV: age, BMI, type 1 diabetes, and low-grade inflammation (R2 = 0.543). In women, these variables were age, BMI, mean arterial pressure, and type 1 diabetes (R2 = 0.550). CONCLUSIONS: Arterial stiffness assessed as aPWV is increased in patients with type 1 diabetes without clinical cardiovascular disease, independently of classical cardiovascular risk factors. In men with type 1 diabetes, low-grade inflammation is independently associated with arterial stiffness.