Association of C2, a derivative of the radial artery pressure waveform, with new onset of type 2 diabetes mellitus: the MESA study

Cardiovascular Diabetology

Nkete I. Forbang¹  Matthew A. Allison²  Carmen A. Peralta³  Daniel A. Duprez⁴  David R. Jacobs⁵  Steven Shea⁶ 

[1] 0000 0001 2107 4242, grid.266100.3, Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA, USA;0000 0001 2107 4242, grid.266100.3, Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA, USA;0000 0004 0419 2708, grid.410371.0, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA;0000 0004 0461 8879, grid.267103.1, VA Medical Center, University of San Francisco, San Francisco, CA, USA;0000000419368657, grid.17635.36, Cardiovascular Division, Department of Medicine, University of Minnesota, 420 Delaware St SE, MMC 508, 55455, Minneapolis, MN, USA;0000000419368657, grid.17635.36, Division of Epidemiology and Community Health School of Public Health, University of Minnesota, Minneapolis, MN, USA;0000000419368729, grid.21729.3f, Department of Medicine, Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA;

关键词: Arterial pressure waveform;    C2;    Incident diabetes type 2;    Cohort study;    Cardiovascular risk factors;   

DOI  :  10.1186/s12933-019-0868-3

来源: publisher

【 摘 要 】

BackgroundAlthough microvascular dysfunction is known to result from diabetes, it might also lead to diabetes. Lower values of C2, a derivative of the radial artery pressure waveform, indicate microvascular dysfunction and predict hypertension and cardiovascular disease (CVD). We studied the association of C2 with incident diabetes in subjects free of overt CVD.MethodsAmong multi-ethnic participants (n = 5214), aged 45–84 years with no diabetes, C2 was derived from the radial artery pressure waveform. Incident diabetes (N = 651) was diagnosed as new fasting glucose ≥ 126 mg/dL or antidiabetic medicine over ~ 10 years. The relative incidence density (RID) for incident diabetes per standard deviation (SD) of C2 was studied during ~ 10 years follow-up using four levels of adjustment.ResultsMean C2 at baseline was 4.58 ± 2.85 mL/mmHg × 100. The RID for incident diabetes per SD of C2 was 0.90 (95% CI 0.82–0.99, P = 0.03). After adjustment for demographics plus body size, the corresponding RID was 0.81 (95% CI 0.73–0.89, P < 0.0001); body mass index (BMI) was the dominant covariate here. After adjustment for demographics plus cardiovascular risk factors, the RID was 0.98 (95% CI 0.89, 1.07, P = 0.63). After adjustment for all the parameters in the previous models, the RID was 0.87 (95% CI 0.78, 0.96, P = 0.006).ConclusionsIn a multi-ethnic sample free of overt CVD and diabetes at baseline, C2 predicted incident diabetes after adjustment for demographics, BMI and CVD risk factors. Differences in arterial blood pressure wave morphology may indicate a long-term risk trajectory for diabetes, independently of body size and the classical risk factors.

【 授权许可】

CC BY