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Hsieh DY, Lai YR, Huang CC, Chen YN, Wu SY, Chiu WC, Cheng BC, Lin TY, Chiang HC, Lu CH. Baroreflex Sensitivity as a Surrogate Biomarker for Concurrently Assessing the Severity of Arterial Stiffness and Cardiovascular Autonomic Neuropathy in Individuals with Type 2 Diabetes. J Pers Med 2024; 14:491. [PMID: 38793073 PMCID: PMC11122369 DOI: 10.3390/jpm14050491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
This study aimed to investigate whether baroreflex sensitivity (BRS) could serve as a reliable metric for assessing cardiovascular autonomic neuropathy (CAN) and concurrently act as a surrogate biomarker for evaluating the severity of arterial stiffness and CAN in individuals diagnosed with type 2 diabetes mellitus (T2DM). Participants underwent brachial-ankle pulse wave velocity (baPWV) as well as autonomic function evaluations encompassing the Sudoscan-based modified composite autonomic scoring scale (CASS), baroreflex sensitivity, and heart rate variability in time domains and frequency domains. Linear regression analysis was performed to evaluate the influence of independent variables on baPWV and modified CASS. Participants with higher baPWV values were older, with longer diabetes duration, lower body weight, body mass index, waist circumference, elevated systolic and diastolic blood pressure, and mean arterial blood pressure. They also exhibited a higher prevalence of retinopathy as the underlying disease and reduced estimated glomerular filtration rate. Multiple linear regression analysis revealed that age and BRS were significantly associated with baPWV while diabetes duration, UACR, and BRS were significantly associated with modified CASS. Our study confirms the significant association of BRS with baPWV and modified CASS in T2DM, highlighting its pivotal role in linking microvascular and macrovascular complications. This supports BRS as a surrogate marker for assessing both the severity of arterial stiffness and cardiovascular autonomic neuropathy in T2DM, enabling the early identification of complications.
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Affiliation(s)
- Dong-Yi Hsieh
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (D.-Y.H.); (Y.-R.L.); (H.-C.C.)
| | - Yun-Ru Lai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (D.-Y.H.); (Y.-R.L.); (H.-C.C.)
- Department of Hyperbaric Oxygen Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
| | - Chih-Cheng Huang
- Department of Neurology, Chi-Mei Medical Center, Tainan City 73657, Taiwan;
| | - Yung-Nien Chen
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (Y.-N.C.); (W.-C.C.); (B.-C.C.)
| | - Szu-Ying Wu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan;
| | - Wen-Chan Chiu
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (Y.-N.C.); (W.-C.C.); (B.-C.C.)
| | - Ben-Chung Cheng
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (Y.-N.C.); (W.-C.C.); (B.-C.C.)
| | - Ting-Yin Lin
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan;
| | - Hui-Ching Chiang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (D.-Y.H.); (Y.-R.L.); (H.-C.C.)
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (D.-Y.H.); (Y.-R.L.); (H.-C.C.)
- Department of Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
- Department of Biological Science, National Sun Yat-Sen University, Kaohsiung City 80424, Taiwan
- Department of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen 361126, China
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Hu F, Zhou W, Wang T, Yu C, Zhu L, Bao H, Cheng X. Association between six different types of anthropometric indices and arterial stiffness measured by brachial-ankle pulse wave velocity in hypertensive Chinese adults. Heliyon 2024; 10:e28523. [PMID: 38601660 PMCID: PMC11004534 DOI: 10.1016/j.heliyon.2024.e28523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
Background The associations of body fat parameters with arterial stiffness measured by brachial-ankle pulse wave velocity in hypertensive patients were scarce. Methods This cross-sectional study analyzed 4322 hypertensive adults. The correlations between the anthropometric indexes (body mass index [BMI], waist circumference, waist-tohip ratio [WHR], waist-to-height ratio [WHtR], a body shape index [ABSI], body round index [BRI]) and ba-PWV values were analyzed using multivariable linear regression model. Results In both sex categories, linear regression models showed that BMI levels were inversely related to baPWV (adjusted-β per SD increase in male: -0.51, 95% CI -0.66 to -0.36, P < 0.001; female: -0.50, 95% CI -0.63 to -0.37, P < 0.001). Waist circumference positively correlated with baPWV only in male hypertensive individuals. BaPWV positively correlated to WHR or WHtR levels (adjusted-β per SD increase: 0.32, 95% CI 0.21 to 0.43, P < 0.001; 0.64, 95% CI 0.47 to 0.82, P < 0.001; respectively), ABSI (adjusted-β per SD increase for ABSI × 100: 0.27, 95% CI 0.18 to 0.36, P < 0.001) and BRI (adjusted-β per SD increase: 0.64, 95% CI 0.46 to 0.81, P < 0.001) levels. The relationship between anthropometric indices and arterial stiffness based on baPWV values were also consistent. ABSI had the highest predictive power of arterial stiffness (area under the curve, 0.594; P < 0.001). Conclusion In Chinese adults with hypertension, BMI was inversely related to baPWV, while WHR, WHtR, ABSI and BRI were positively related. Waist circumference positively correlated with baPWV only in male hypertensive individuals.
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Affiliation(s)
- Feng Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, 350000, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Zhao L, Zhou X, Chen Y, Dong Q, Zheng Q, Wang Y, Li L, Zhao D, Ji B, Xu F, Shi J, Peng Y, Zhang Y, Dai Y, Ke T, Wang W. Association of visceral fat area or BMI with arterial stiffness in ideal cardiovascular health metrics among T2DM patients. J Diabetes 2024; 16:e13463. [PMID: 37680102 PMCID: PMC10809303 DOI: 10.1111/1753-0407.13463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 07/09/2023] [Accepted: 08/04/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND "Obesity paradox" occurs in type 2 diabetes mellitus (T2DM) patients when body mass index (BMI) is applied to define obesity. We examined the association of visceral fat area (VFA) as an obesity measurement with arterial stiffness in seven ideal cardiovascular health metrics (ICVHMs). METHODS A total of 29 048 patients were included in the analysis from June 2017 to April 2021 in 10 sites of National Metabolic Management Centers. ICVHMs were modified from the recommendations of the American Heart Association. Brachial-ankle pulse wave velocity (BaPWV) ≥ 1400 cm/s was employed to evaluate increased arterial stiffness. Multivariate regression models were used to compare the different effects of BMI and VFA on arterial stiffness. RESULTS Lower VFA was more strongly associated with low BaPWV than lower BMI when other ICVHMs were included (adjusted odds ratio [OR], 0.85 [95% confidence interval [CI], 0.80-0.90] vs OR 1.08 [95% CI, 1.00-1.17]). Multivariable-adjusted ORs for arterial stiffness were highest in patients with the VAT area VFA in the range of 150-200 cm2 (adjusted OR, 1.26 [95% CI 1.12-1.41]). Compared with participants with VAT VFA < 100 cm2 , among participants with higher VAT VFA, the OR for arterial stiffness decreased gradually from 1.89 (95% CI, 1.73-2.07) in patients who had ≤1 ICVHM to 0.39 (95% CI, 0.25-0.62) in patients who had ≥5 ICVHMs. CONCLUSION In patients with T2DM, using VAT for anthropometric measures of obesity, VFA was more relevant to cardiovascular risk than BMI in the seven ICVHMs. For anthropometric measures of obesity in the ICVHMs to describe cardiovascular risk VFA would be more optimal than BMI.
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Affiliation(s)
- Ling Zhao
- Department of EndocrinologyThe Second Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Xiangming Zhou
- Department of EndocrinologyThe Second Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Yufei Chen
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic DiseasesKey Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor,State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Qijuan Dong
- Department of EndocrinologyPeople's Hospital of Zhengzhou Affiliated Henan University of Chinese MedicinezhengzhouChina
| | - Qidong Zheng
- Department of Internal MedicineThe Second People's Hospital of YuhuanYuhuanChina
| | - Yufan Wang
- Department of Endocrinology and MetabolismShanghai General Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Li Li
- Department of EndocrinologyNingbo First HospitalNingboChina
| | - Dong Zhao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe HospitalCapital Medical UniversityBeijingChina
| | - Bangqun Ji
- Department of EndocrinologyXingyi People's HospitalXingyiChina
| | - Fengmei Xu
- Department of Endocrinology and MetabolismHebi Coal (group). LTD. General HospitalHebiChina
| | - Juan Shi
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic DiseasesKey Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor,State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Ying Peng
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic DiseasesKey Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor,State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yifei Zhang
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic DiseasesKey Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor,State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yuancheng Dai
- Department of Internal Medicine of Traditional Chinese MedicineSheyang Diabetes HospitalYanchengChina
| | - Tingyu Ke
- Department of EndocrinologyThe Second Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Weiqing Wang
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic DiseasesKey Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor,State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
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Huang Y, Zhao L, Cai M, Zhu J, Wang L, Chen X, Zeng Y, Zhang L, Shi J, Guo CF. Arteriosclerosis Assessment Based on Single-Point Fingertip Pulse Monitoring Using a Wearable Iontronic Sensor. Adv Healthc Mater 2023; 12:e2301838. [PMID: 37602671 DOI: 10.1002/adhm.202301838] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/09/2023] [Indexed: 08/22/2023]
Abstract
Arteriosclerosis, which appears as a hardened and narrowed artery with plaque buildup, is the primary cause of various cardiovascular diseases such as stroke. Arteriosclerosis is often evaluated by clinically measuring the pulse wave velocity (PWV) using a two-point approach that requires bulky medical equipment and a skilled operator. Although wearable photoplethysmographic sensors for PWV monitoring are developed in recent years, likewise, this technique is often based on two-point measurement, and the signal can easily be interfered with by natural light. Herein, a single-point strategy is reported based on stable fingertip pulse monitoring using a flexible iontronic pressure sensor for heart-fingertip PWV (hfPWV) measurement. The iontronic sensor exhibits a high pressure-resolution on the order of 0.1 Pa over a wide linearity range, allowing the capture of characteristic peaks of fingertip pulse waves. The forward and reflected waves of the pulse are extracted and the time difference between the two waves is computed for hfPWV measurement using Hiroshi's method. Furthermore, a hfPWV-based model is established for arteriosclerosis evaluation with an accuracy comparable to that of existing clinical criteria, and the validity of the model is verified clinically. The work provides a reliable technique that can be used in wearable arteriosclerosis assessment systems.
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Affiliation(s)
- Yi Huang
- Department of Cardiology, Southern University of Science and Technology Hospital (SUSTech-Hospital), Shenzhen, 518071, China
| | - Lingyu Zhao
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Minkun Cai
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Jiaqi Zhu
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Liu Wang
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, University of Science and Technology of China, Hefei, 230026, China
| | - Xinxing Chen
- Shenzhen Key Laboratory of Biomimetic Robotics and Intelligent Systems, Guangdong Provincial Key Laboratory of Human-Augmentation and Rehabilitation Robotics in Universities, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Yumin Zeng
- Department of Sports Center, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Liqing Zhang
- Department of Endocrinology, Southern University of Science and Technology Hospital (SUSTech-hospital), Shenzhen, 518071, China
| | - Jidong Shi
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, College of Engineering Physics, Shenzhen Technology University, Shenzhen, 518118, China
| | - Chuan Fei Guo
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
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Zhao X, Cai Q, Dong L, Zhang X, Wang C, Wang S, Liu L, Hu A. Association between length of daily siesta and brachial-ankle pulse wave velocity (baPWV): a community-based cross sectional study in North China. Sleep Breath 2023; 27:1819-1828. [PMID: 36826736 DOI: 10.1007/s11325-023-02791-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION To date, many studies have shown a link between siesta and cardiovascular events. Little is known regarding the connection between siesta and brachial-ankle pulse wave velocity (baPWV) levels, even though baPWV can determine the degree of atherosclerosis and vascular stiffness. Thus, we examined the relationship between siesta time and baPWV in a cross-sectional study. METHODS Interviews, physical examinations, lab testing, and electron beam computed tomography were all part of the baseline evaluation for participants aged older than 35. Baseline data were compared for 3 different siesta habits: irregular or no siestas, daily short siestas (1 h or less), and daily long siestas (> 1 h). Utilizing logistic regression models and multivariate linear regression, the link between siesta time and baPWV was determined. RESULTS Among all 6566 participants, the different siesta groups had a significant difference of the degrees of AS (P < 0.001). The same outcome was true for both males (P < 0.001) and females (P < 0.001). Numerous cardiovascular risk variables and markers of subclinical atherosclerosis were positively correlated with daily extended siestas. Results from the fully adjusted model showed that long siestas (> 60 min, OR = 1.18, 95%CI: 1.06-1.31, P = 0.002) were linked to a more severe level of the baPWV. For age or gender stratification, we found significant differences between non-siesta and > 60 min siesta groups. Multiple linear regression analysis revealed a positive connection between siesta duration and baPWV (β = 0.197, P = 0.038). CONCLUSIONS An elevated risk of atherosclerosis was shown to accompany prolonged siestas. These results need to be followed up on with prospective studies and additional lab work.
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Affiliation(s)
- Xiaolei Zhao
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Qiujing Cai
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Liguang Dong
- Peking University Shougang Hospital, Beijing, 100144, China
| | - Xinmin Zhang
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Chenglong Wang
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Shuyu Wang
- Beijing Hypertension League Institute, Beijing, 100039, China
| | - Lisheng Liu
- Beijing Hypertension League Institute, Beijing, 100039, China
| | - Aihua Hu
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Beijing Hypertension League Institute, Beijing, 100039, China
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Xiong Y, Shi W, Huang X, Yu C, Zhou W, Bao H, Cheng X. Association between weight-adjusted waist index and arterial stiffness in hypertensive patients: The China H-type hypertension registry study. Front Endocrinol (Lausanne) 2023; 14:1134065. [PMID: 37008949 PMCID: PMC10064138 DOI: 10.3389/fendo.2023.1134065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
Objective Exploring the relationship between (weight-adjusted waist index) WWI and arterial stiffness (AS) in the total and different BMI populations among patients with hypertension. Methods This study enrolled 5232 hypertensive subjects, a subset of the China H-type Hypertension Registry Study. WWI was calculated as WC (cm) divided by the square root of weight (kg). Brachial-ankle pulse wave velocity (baPWV) was measured to determine AS. Results The mean WWI was 10.97 (0.78)cm/√kg. In multiple logistic analyses showed that there were significant dose-dependent association between WWI with baPWV in a dose-dependent manner in total population (β 57.98, 95% CI 44.06-71.90), and in different BMI group: group 1 (BMI<18.5kg/m2) (β 94.30, 95% CI 39.36-149.23), group 2 (18.5-23.9kg/m2) (β 74.21, 95% CI 54.57-93.85), group 3 (≥24kg/m2) (β 26.11, 95% CI 5.22-47.01). In stratified analysis, stronger associations between WWI and baPWV were observed in patients with higher BP or lower BMI. Sensitivity analysis by excluding patients treated with lipid-lowering agents did not change the association between WWI and baPWV. Conclusion For hypertensive patients, we found that WWI was positively associated with baPWV in different BMI groups. WWI might be considered as an intervening factor in preventing and treatment of AS, besides BP management.
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Affiliation(s)
- Yurong Xiong
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, China
| | - Weidong Shi
- Department of Cardiovascular Medicine, Wuyuan People’s Hospital, Shangrao, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, China
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, China
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Li X, Yu J, Bai J, Huang H, Ying S, Wang A, Wang P. Interaction Between Obesity and Hypertension on Arteriosclerosis in Chinese Urban Adults: A Population-Based Cross-Sectional Study. Clin Nurs Res 2023; 32:629-638. [PMID: 36169279 DOI: 10.1177/10547738221120733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study recruited 9,830 participants to identify whether the interaction between obesity and hypertension affects the occurrence of arteriosclerosis in Chinese adults. Brachial-ankle pulse wave velocity (baPWV) was measured to diagnose arteriosclerosis. Unconditional logistic regression was used for multiplicative interaction. The additive interaction was represented by relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy (S). Hypertension was an independent risk factor for baPWV (p < .01), but obesity was not (p = .08). The interaction between obesity and hypertension on arteriosclerosis was not multiplicative (adjusted odds ratio = 0.89 (0.79-1.01), p = .07), but a negative additive interaction (RERI = -4.33, AP = -2.91, S = 0.10; p < .01) exists. Therefore, obesity may reduce the risk of arteriosclerosis caused by hypertension when hypertension and obesity coexist, especially in women and middle-aged people, which supports the obesity paradox.
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Affiliation(s)
- Xiaohan Li
- Faculty of Sport Science, Research Academy of Grand Health, Ningbo University, China
| | - Junwu Yu
- Ningbo Puyuanphysio Clinic, China.,Ningbo College of Health Sciences, China
| | | | - Huiming Huang
- Faculty of Sport Science, Research Academy of Grand Health, Ningbo University, China
| | - Shanshan Ying
- Faculty of Sport Science, Research Academy of Grand Health, Ningbo University, China
| | - Aiwen Wang
- Faculty of Sport Science, Research Academy of Grand Health, Ningbo University, China
| | - Ping Wang
- Lingnan Normal University, Zhanjiang, China
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Xu K, Zheng Q, Shao J, Yang L, Dai Y, Zhang J, Liang Y, Huang W, Liu Y, Cheng J, Pan Y, Yang M, Tang L, Du C. Sex differences in the association between visceral adipose tissue and atherosclerosis in type 2 diabetes patients with normal bodyweight: A study in a Chinese population. J Diabetes Investig 2022; 14:92-101. [PMID: 36161704 PMCID: PMC9807154 DOI: 10.1111/jdi.13913] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 08/17/2022] [Accepted: 09/07/2022] [Indexed: 01/07/2023] Open
Abstract
AIMS/INTRODUCTION To investigate the impact of visceral adipose tissue (VAT) on atherosclerosis in type 2 diabetes patients with normal bodyweight (OB[-]) in the Chinese population, and to further assess the sex-age differences between them. MATERIALS AND METHODS A total of 8,839 type 2 diabetes patients from two of the National Metabolic Management Centers in China were included in this study. Participants were classified into four groups by visceral fat area (VFA; cm2 ) and body mass index (BMI; kg/m2 ): VFA < 100 and BMI < 23.9 (VA[-]OB[-]), VFA < 100 and BMI ≥ 23.9 (VA[-]OB[+]), VFA ≥ 100 and BMI < 23.9 (VA[+]OB[-]), VFA ≥ 100 and BMI ≥ 23.9 (VA[+]OB[+]). Atherosclerosis was defined by brachial-ankle pulse wave velocity (baPWV; cm/s), and we analyzed the association between VFA, BMI and the tertiles of baPWV values. RESULTS The VA(+)OB(-) prevalence was 3.7% among these participants. Patients with VA(+)OB(-) had the highest baPWV value (P < 0.001) and the highest proportion of the tertile 3 of baPWV (P < 0.001) among four groups, and were significantly associated with baPWV (standardized β = 0.026, P = 0.008). VFA was significantly related to tertile 2 to tertile 3 of baPWV in (OB[-]) type 2 diabetes patients, when compared with tertile 1 of baPWV, respectively. In sex-age stratified analysis, the association of VFA and the tertiles of baPWV showed sex differences. For the 55 years age stratification analysis, there was no age difference in the relationship between VFA and baPWV in (OB[-]) patients. CONCLUSION Increased VAT was an independent risk factor for atherosclerosis in female type 2 diabetes patients with normal weight.
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Affiliation(s)
- Kun Xu
- Department of Internal MedicineShengzhou Hospital of Traditional Chinese MedicineShengzhouChina
| | - Qidong Zheng
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Jianlin Shao
- Zhejiang Provincial Center for Cardiovascular Disease Prevention and ControlZhejiang HospitalHangzhouChina
| | - Lin Yang
- Department of Geriatrics, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Yuancheng Dai
- Department of Internal Medicine of Traditional Chinese MedicineSheyang Diabetes Specialist HospitalYanchengChina
| | - Jingyuan Zhang
- Department of Medicine, The Second College of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouChina
| | - Yao Liang
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Wenhao Huang
- Department of Medicine, The Second College of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouChina
| | - Yajun Liu
- Department of Medicine, The Second College of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouChina
| | - Jian Cheng
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Yuping Pan
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Mengyao Yang
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Lijiang Tang
- Department of CardiologyZhejiang HospitalHangzhouChina
| | - Changqing Du
- Department of CardiologyZhejiang HospitalHangzhouChina
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9
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Li L, Xie W, Li Q, Hong H. The positive correlation between brachial-ankle pulse wave velocity and aortic diameter in Chinese patients with diabetes. J Clin Hypertens (Greenwich) 2022; 24:1059-1067. [PMID: 35894781 PMCID: PMC9380158 DOI: 10.1111/jch.14548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/16/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
Abstract
Aortic dilation is associated with an increased risk of cardiovascular diseases. Increased brachial-ankle pulse wave velocity (baPWV) is a hallmark of vascular aging and arterial stiffness, as well as an important risk factor for vascular disease. This study aimed to retrospectively analyze the correlation between baPWV and aortic diameter (AoD) of inpatients with diabetes. A total of 1294 diabetic patients with the detailed medical records were investigated. Arterial stiffness was assessed using baPWV and AoD using echocardiography. The results showed that baPWV and AoD increase with age (p <0.05). Based on multiple linear regression analysis, age, systolic and diastolic blood pressure, left atrial diameter, right ventricle diameter, pulmonary artery diameter, peak velocity of early transmitral blood flow/peak velocity of late transmitral blood flow, and baPWV independently correlated with AoD in patients with diabetes. Additionally, an increased risk of aortic dilation occurred in the highest baPWV quartile compared with the lowest quartile (p <0.001). In conclusion, baPWV is independently and positively associated with AoD. Hence, prospective cohorts or randomized clinical trials will be the next step to further determine whether interventions designed to improve arterial stiffness in patients with diabetes will reduce the risk of aortic dilation.
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Affiliation(s)
- Liping Li
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Department of Cardiology, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Wenhui Xie
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Department of Cardiology, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Qingqing Li
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Department of Cardiology, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Huashan Hong
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Department of Cardiology, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
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10
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Tian X, Zuo Y, Chen S, Zhang Y, Zhang X, Xu Q, Wu S, Wang A. Hypertension, Arterial Stiffness, and Diabetes: a Prospective Cohort Study. Hypertension 2022; 79:1487-1496. [PMID: 35574838 PMCID: PMC9172905 DOI: 10.1161/hypertensionaha.122.19256] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Whether the combination of different blood pressure and arterial stiffness (AS) status is independently associated with diabetes has not been fully investigated so far. This study aimed at investigating the status of hypertension and AS in determining diabetes.
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Affiliation(s)
- Xue Tian
- Department of Neurology (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China.,China National Clinical Research Center for Neurological Diseases (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China (X.T., Y.Z.).,Beijing Municipal Key Laboratory of Clinical Epidemiology, China (X.T., Y.Z.)
| | - Yingting Zuo
- Department of Neurology (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China.,China National Clinical Research Center for Neurological Diseases (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China (X.T., Y.Z.).,Beijing Municipal Key Laboratory of Clinical Epidemiology, China (X.T., Y.Z.)
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China (S.C., S.W.)
| | - Yijun Zhang
- Department of Neurology (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China.,China National Clinical Research Center for Neurological Diseases (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China
| | - Xiaoli Zhang
- Department of Neurology (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China.,China National Clinical Research Center for Neurological Diseases (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China
| | - Qin Xu
- Department of Neurology (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China.,China National Clinical Research Center for Neurological Diseases (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China (S.C., S.W.)
| | - Anxin Wang
- Department of Neurology (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China.,China National Clinical Research Center for Neurological Diseases (X.T., Y.Z., Y.Z., X.Z., Q.X., A.W.), Beijing Tiantan Hospital, Capital Medical University, China
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11
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Yang X, Gao Z, Huang X, Zhang M, Chen Z. The correlation of atherosclerosis and triglyceride glucose index: a secondary analysis of a national cross-sectional study of Japanese. BMC Cardiovasc Disord 2022; 22:250. [PMID: 35659558 PMCID: PMC9164853 DOI: 10.1186/s12872-022-02685-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/20/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Few studies examined the relationship between triglyceride/glucose index (TyG index) and atherosclerosis in Japanese adults. Therefore, this study evaluated their relationship, as measured based on the brachial-ankle pulse wave velocity (baPWV) in Japanese adults. METHODS A total of 912 participants was selected from the NAGALA (NAFLD in Gifu Area, Longitudinal Analysis) study conducted from 2004 to 2012. The relationship between the TyG index and baPWV was estimated through a logistic model. Subgroup analyses by sex, age, body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol, estimated glomerular filtration rate (eGFR), and fatty liver was performed. The formula for TyG index was ln (½fasting triglyceride level [mg/dL] × fasting plasma glucose level [mg/dL]). RESULTS A linear relationship between TyG and baPWV was discovered after adjusting for underlying confounders. An increased risk of baPWV was observed after adjusting for sex, age, BMI, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, fatty liver, eGFR, and TyG as a continuous variable (adjusted odds ratio [adj OR], 1.57; 95% confidence interval [95% CI], 1.14-2.18). Compared with the TyG index in the first tertile, the probabilities of subjects in the third tertile that developed to baPWV were 1.78-fold higher (adj OR 1.78, 95% CI 1.08-2.95: P for trend 0.024). Moreover, stable associations were observed between the TyG index and baPWV in different variables through subgroup analyses. CONCLUSIONS The highest tertile (above 8.57) of the TyG index was positively and linearly related to subclinical atherosclerosis in Japanese adults and may be valuable as a predicted marker.
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Affiliation(s)
- Xingping Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510105, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Zhao Gao
- Office of Academic Research, Er Sha Sports Training Center of Guangdong Province, Guangzhou, 510105, China
| | - Xuming Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Mingxing Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Zhuoming Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510105, China.
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12
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Hu W, Zhang H, Liu Z, Duan Q, Liu J, Dong Q, You L, Wen X, Zhang D. The Relationship Between Adipose Tissue Distribution and Arterial Stiffness in HFpEF. Nutrition 2022; 102:111726. [DOI: 10.1016/j.nut.2022.111726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/22/2022] [Accepted: 04/28/2022] [Indexed: 12/09/2022]
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13
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Zhang H, Gao H, Zhu Y, Zhu Y, Dang W, Wei R, Yan H. Relationship Between Myopia and Other Risk Factors With Anxiety and Depression Among Chinese University Freshmen During the COVID-19 Pandemic. Front Public Health 2021; 9:774237. [PMID: 34926391 PMCID: PMC8671746 DOI: 10.3389/fpubh.2021.774237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose: To investigate the association of myopia and other risk factors with anxiety and depression among Chinese university freshmen during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study was conducted at the Tianjin Medical University from October 2020 to December 2020. Ophthalmic examination of the eyes was performed by an experienced ophthalmologist. Detailed information on depression, anxiety, and other risk factors was collected via the Self-rating Anxiety Scale and Self-rating Depression Scale. Results: The overall prevalence of anxiety and depression in our study was 10.34 and 25.13%, respectively. The prevalence of myopia and high myopia as 92.02 and 26.7%, respectively. There were significant associations between anxiety and spectacle power [odds ratios (OR) = 0.89; 95% CI: 0.81–0.98, P = 0.019], sphere equivalent (OR = 0.89; 95% CI: 0.81– 0.98, P = 0.025), sleep time (OR = 0.53; 95% CI: 0.35–0.79, P = 0.002), and body mass index (OR = 0.93; 95% CI: 0.86–0.99, P = 0.047). In the multivariable linear regression models, spectacle power (β = −0.43; 95% CI: −0.68 to −0.19, P = 0.001) and sphere equivalent (β = −0.36; 95% CI: −0.60 to −0.11, P = 0.005) were negatively associated with anxiety scores, whereas axial length (β = 0.54; 95% CI: 0.02–1.07, P = 0.044) was positively correlated with anxiety scores. Every 1 h decrease in sleep time was associated with a 0.12-point increase in depression score. Conclusion: Myopia was associated with anxiety and anxiety scores. The greater the degree of myopia, the higher the anxiety score. However, myopia was not found to be associated with depression. The results highlight the importance of providing psychological support to students with myopia during the COVID-19 pandemic.
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Affiliation(s)
- Hongmei Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Huijuan Gao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yun Zhu
- Department of Epidemiology and Biostatistics, Tianjin Medical University, Tianjin, China
| | - Ying Zhu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Weiyu Dang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
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14
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Hu F, Yu R, Han F, Li J, Zhou W, Wang T, Zhu L, Huang X, Bao H, Cheng X. Does body mass index or waist-hip ratio correlate with arterial stiffness based on brachial-ankle pulse wave velocity in Chinese rural adults with hypertension? BMC Cardiovasc Disord 2021; 21:573. [PMID: 34852784 PMCID: PMC8638469 DOI: 10.1186/s12872-021-02390-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 11/12/2021] [Indexed: 02/07/2023] Open
Abstract
Background The relationship between obesity indices and arterial stiffness (AS) has not been fully discovered nor has it been studied in depth in large hypertensive patient populations. The aim of this study was to explore the association between body mass index (BMI) and waist-hip ratio (WHR) levels and AS based on brachial-ankle pulse wave velocity (baPWV) in Chinese rural adults with hypertension. Methods This cross-sectional study analyzed 5049 Chinese rural adults with essential hypertension. BMI was calculated as the body weight in kilograms divided by the square of the height in meters (kg/m2). Central obesity was defined as WHR ≥ 0.9 for males and ≥ 0.85 for females. Measurement of arterial stiffness was carried out via brachial-ankle pulse wave velocity (baPWV). Results The prevalence of overweight, general obesity, central obesity and increased AS were 26.88%, 3.39%, 63.85% and 44.01%, respectively. Multivariate logistic regression analysis indicated that BMI levels were negatively associated with the prevalence of increased AS (adjusted-OR per SD increase: 0.74, 95% CI 0.67–0.81, P < 0.001). When BMI was instead treated as a categorical variable divided into tertiles, the same relationship was observed (P for trend < 0.001). Inversely, WHR levels were positively associated with the prevalence of increased AS (adjusted-OR per SD increase: 1.25, 95% CI 1.14–1.36, P < 0.001). Compared to subjects without central obesity, those with central obesity had a higher prevalence of increased AS (adjusted-OR: 1.52, 95% CI 1.28–1.81, P < 0.001). Linear regression models indicated similar results in the correlation between BMI or WHR levels and baPWV levels (adjusted-β per SD increase: − 0.57, 95% CI − 0.68 to − 0.46, P < 0.001; adjusted-β per SD increase: 4.46, 95% CI 3.04–5.88, P < 0.001). There were no interactions in terms of age and blood pressure on the relationship between BMI or WHR levels and the prevalence of increased AS or baPWV levels. Conclusion There was an inverse relationship between BMI levels and increased AS or baPWV levels, whereas WHR levels and central obesity were positively associated with increased AS or baPWV levels in Chinese rural adults with hypertension. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02390-y.
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Affiliation(s)
- Feng Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Rihua Yu
- Department of General Practice Medicine, Zhentou Town Health Center, Wuyuan, Jiangxi, China
| | - Fengyu Han
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Juan Li
- The College of Pharmacy, Nanchang University, Nanchang, Jiangxi, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China. .,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China. .,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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15
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Wen J, Zhang Q, Yang Q, Hu F. The levels of hemoglobin are positively associated with arterial stiffness in community-dwelling Chinese adults. Nutr Metab Cardiovasc Dis 2021; 31:2929-2934. [PMID: 34364772 DOI: 10.1016/j.numecd.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/02/2021] [Accepted: 07/04/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS Hemoglobin (Hb) concentrations are known to be related to cardiovascular diseases. This study investigated the association between Hb levels and arterial stiffness, as assessed by measurement of the brachial-ankle pulse wave velocity (baPWV). METHODS AND RESULTS 3576 adults (2139 males and 1437 females) from the general Chinese population who had their physical check-ups in the health examination centers of Jiangmen Central Hospital were enrolled into the study. The anthropometrics and laboratory data as well as the baPWV and Hb levels were subsequently obtained. Age-adjusted partial correlation and multivariable stepwise linear regression analyses were used to evaluate the relationships between Hb and baPWV for men and women separately. In both sexes, Hb levels were positively associated with body mass index, total cholesterol, low-density lipoprotein cholesterol, triglycerides, glutamic-pyruvic transaminase, γ-glutamyltranspeptidase, uric acid and baPWV, but negatively correlated with the estimated glomerular filtration rate. Multivariable linear regression analysis showed that Hb was significantly and independently associated with arterial stiffness in men (β = 0.043, 95% CI 0.010-0.077, p < 0.05) and women (β = 0.035, 95% CI 0.001-0.069, P < 0.05), after adjustment for confounding factors. CONCLUSION The data indicate that high Hb concentration significantly correlate with increased baPWV in general Chinese population.
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Affiliation(s)
- Jianghua Wen
- Department of Health Examination, Jiangmen Central Hospital, Jiangmen, 529070, Guangdong, China
| | - Qinqin Zhang
- Department of Thyroid and Breast Surgery, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin 541002, Guangxi, China.
| | - Qiong Yang
- Department of Endocrinology, Guilin Medical University Affiliated Hospital, Guilin 541001, Guangxi, China.
| | - Fang Hu
- Department of Endocrinology, The Fifth Affiliated Hospital, Sun Yat-Sen University, 52 Meihua East Road, Zhuhai 519000, Guangdong, China
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16
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Li Q, Xie W, Li L, Wang L, You Q, Chen L, Li J, Ke Y, Fang J, Liu L, Hong H. Development and Validation of a Prediction Model for Elevated Arterial Stiffness in Chinese Patients With Diabetes Using Machine Learning. Front Physiol 2021; 12:714195. [PMID: 34497538 PMCID: PMC8419456 DOI: 10.3389/fphys.2021.714195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023] Open
Abstract
Background Arterial stiffness assessed by pulse wave velocity is a major risk factor for cardiovascular diseases. The incidence of cardiovascular events remains high in diabetics. However, a clinical prediction model for elevated arterial stiffness using machine learning to identify subjects consequently at higher risk remains to be developed. Methods Least absolute shrinkage and selection operator and support vector machine-recursive feature elimination were used for feature selection. Four machine learning algorithms were used to construct a prediction model, and their performance was compared based on the area under the receiver operating characteristic curve metric in a discovery dataset (n = 760). The model with the best performance was selected and validated in an independent dataset (n = 912) from the Dryad Digital Repository (https://doi.org/10.5061/dryad.m484p). To apply our model to clinical practice, we built a free and user-friendly web online tool. Results The predictive model includes the predictors: age, systolic blood pressure, diastolic blood pressure, and body mass index. In the discovery cohort, the gradient boosting-based model outperformed other methods in the elevated arterial stiffness prediction. In the validation cohort, the gradient boosting model showed a good discrimination capacity. A cutoff value of 0.46 for the elevated arterial stiffness risk score in the gradient boosting model resulted in a good specificity (0.813 in the discovery data and 0.761 in the validation data) and sensitivity (0.875 and 0.738, respectively) trade-off points. Conclusion The gradient boosting-based prediction system presents a good classification in elevated arterial stiffness prediction. The web online tool makes our gradient boosting-based model easily accessible for further clinical studies and utilization.
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Affiliation(s)
- Qingqing Li
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wenhui Xie
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Liping Li
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Lijing Wang
- Department of Endocrinology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Qinyi You
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Lu Chen
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jing Li
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yilang Ke
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jun Fang
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Libin Liu
- Department of Endocrinology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huashan Hong
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
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Li Q, Xie W, Li L, Wang L, You Q, Chen L, Li J, Ke Y, Fang J, Liu L, Hong H. Development and Validation of a Prediction Model for Elevated Arterial Stiffness in Chinese Patients With Diabetes Using Machine Learning. Front Physiol 2021. [DOI: 10.3389/fphys.2021.714195
expr 962169460 + 908583142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
BackgroundArterial stiffness assessed by pulse wave velocity is a major risk factor for cardiovascular diseases. The incidence of cardiovascular events remains high in diabetics. However, a clinical prediction model for elevated arterial stiffness using machine learning to identify subjects consequently at higher risk remains to be developed.MethodsLeast absolute shrinkage and selection operator and support vector machine-recursive feature elimination were used for feature selection. Four machine learning algorithms were used to construct a prediction model, and their performance was compared based on the area under the receiver operating characteristic curve metric in a discovery dataset (n = 760). The model with the best performance was selected and validated in an independent dataset (n = 912) from the Dryad Digital Repository (https://doi.org/10.5061/dryad.m484p). To apply our model to clinical practice, we built a free and user-friendly web online tool.ResultsThe predictive model includes the predictors: age, systolic blood pressure, diastolic blood pressure, and body mass index. In the discovery cohort, the gradient boosting-based model outperformed other methods in the elevated arterial stiffness prediction. In the validation cohort, the gradient boosting model showed a good discrimination capacity. A cutoff value of 0.46 for the elevated arterial stiffness risk score in the gradient boosting model resulted in a good specificity (0.813 in the discovery data and 0.761 in the validation data) and sensitivity (0.875 and 0.738, respectively) trade-off points.ConclusionThe gradient boosting-based prediction system presents a good classification in elevated arterial stiffness prediction. The web online tool makes our gradient boosting-based model easily accessible for further clinical studies and utilization.
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Qu G, Zhang Z, Zhu H. Association Between Blood Pressure Control and Arterial Stiffness in Middle-Aged and Elderly Chinese Patients with Hypertension. Med Sci Monit 2021; 27:e931414. [PMID: 34420028 PMCID: PMC8388207 DOI: 10.12659/msm.931414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The severity of arterial stiffness can be evaluated by pulse wave velocity (PWV). This study investigated the association between blood pressure (BP) control and arterial stiffness in middle-aged and elderly Chinese patients with hypertension. Material/Methods Three hundred and twelve hypertensive patients were divided according to whether their hypertension was well-controlled or uncontrolled and stratified according to age. Arterial stiffness was evaluated by brachial-ankle pulse wave velocity (baPWV). The effect of BP control on arterial stiffness and its severity was assessed by multivariate linear and logistic regression analyses. Results Moderate and severe arterial stiffness was detected significantly more often in patients with uncontrolled hypertension than in those with well-controlled hypertension, regardless of age. BaPWV increased by 8.467 cm/s in the study population overall for every 1-mmHg increment in systolic BP and by 8.584, 8.616, and 8.199 cm/s, respectively, in patients aged 45–65, 65–80, and ≥80 years. Regardless of age, the risk of arterial stiffness was 5.93 times higher (95% confidence interval 2.78–12.64) and the risk of a one-grade increase in the severity of arterial stiffness was 4.01 times higher (95% confidence interval 2.51–6.42) in patients with uncontrolled hypertension than in those with well-controlled hypertension. Conclusions This study found a positive relationship between baPWV and BP and identified uncontrolled BP as a risk factor for arterial stiffness and its severity. Management of BP within a reasonable range may help to ameliorate arterial stiffness.
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Affiliation(s)
- Geyue Qu
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China (mainland)
| | - Zhongying Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China (mainland)
| | - Hong Zhu
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China (mainland)
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Low 25-hydroxyvitamin D is associated with arterial stiffness in Chinese with Type 2 diabetes mellitus. Eur J Clin Nutr 2021; 75:1645-1653. [PMID: 33790397 DOI: 10.1038/s41430-021-00870-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 01/03/2021] [Accepted: 01/26/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Arterial stiffness (AS), one of the complications of diabetes, associated with many metabolic factors. This study aimed to investigate the association between 25-hydroxyvitamin D(25(OH)D) and AS in type 2 diabetes mellitus (T2DM). METHODS We identified 1335 diabetic patients from the Department of Endocrinology, Shanghai Tenth People's Hospital. Finally, 603 T2DM patients were included in the study. They were divided into two groups: AS group (baPWV ≥ 15,500 cm/s) and the control group (baPWV < 1550 cm/s). RESULTS (1) Heart rate (HR) and systolic pressure (SBP) were higher while body weight and body mass index (BMI) were smaller in AS group than the control group (all P < 0.05). (2) Compared to patients without AS, patients with AS showed lower 25(OH)D and higher rate of 25(OH)D deficiency (42 ± 16 vs. 45 ± 17 mol/l, 68% vs. 64%, all P < 0.05). (3) BaPWV was negatively associated with 25(OH)D (r = -0.12, P = 0.004), while positively associated with age, duration of diabetes, HR, SBP, and low-density lipoprotein cholesterol and negatively associated with body weight and BMI (all P < 0.05). (4) Multiple linear regression showed that 25(OH)D was the negatively influencing factor of baPWV (β = -2.2, P = 0.01). Logistic regression showed that age and SBP were risk factor of AS (OR:1.07, 95% CI: 1.05-1.10, P < 0.001; OR:1.03, 95% CI: 1.02-1.04, P < 0.001) while 25(OH)D was protective factor of AS (OR:0.987, 95% CI: 0.976-0.998, P = 0.024). CONCLUSIONS T2DM patients with AS had lower 25(OH)D and higher rate of 25(OH)D deficiency. There was a negative relationship between 25(OH)D and AS assessed by baPWV.
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Tang Z, Lu Y, Hao Y, Morris R, Kang D, Wang F, Fan L, Wang W, Wang Y, Cheng F. The Temporal Pattern of Arterial Stiffness during Aging: A Large-Scale Cross-Sectional Study. J Diabetes Res 2021; 2021:3243135. [PMID: 34926697 PMCID: PMC8683198 DOI: 10.1155/2021/3243135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 11/01/2021] [Accepted: 11/16/2021] [Indexed: 12/22/2022] Open
Abstract
Brachial-ankle pulse wave velocity (baPWV) is a noninvasive clinical test that provides quantification for the stiffness of both the aorta and peripheral arteries by measuring the brachial and tibial arterial wave velocities. The temporal pattern of baPWV values during aging was investigated in this paper. A gradual increase in baPWV with respect to age was observed, suggesting an increase in the stiffness of arterial vessels as age increases. The ΔbaPWV value, defined as the absolute value of the difference between bilateral baPWV, also showed a positive correlation with aging. Many underlying physiological conditions such as hyperlipidemia, hypertension, diabetes, and hyperglycemia have previously been shown to elevate baPWV and contribute to the decline of arterial function. The effect of factors including biological sex, blood pressure, and blood glucose levels on the baPWV temporal pattern were also investigated. Between the ages of 18 and 50, men in the study had significantly higher baPWV readings than females of comparable age on average. However, after the age of 50, mean baPWV values increased at a greater rate in females than in males. In addition, blood pressure and blood glucose were shown to be associated with baPWV values. The results will improve existing prediction models for future cardiovascular episodes induced by arterial hardening in different age groups.
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Affiliation(s)
- Zhengli Tang
- Shuguang Hospital Health Examination Center Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yuanyuan Lu
- Department of Biostatistics and Epidemiology, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Yiming Hao
- Shanghai Key Laboratory of Health Identification and Assessment/Laboratory of Traditional Chinese Medicine Four Diagnostic Information, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Robert Morris
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
| | - Di Kang
- Department of Biostatistics and Epidemiology, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Fang Wang
- Shuguang Hospital Health Examination Center Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Lin Fan
- Shuguang Hospital Health Examination Center Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Weijian Wang
- Shuguang Hospital Health Examination Center Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yiqin Wang
- Shanghai Key Laboratory of Health Identification and Assessment/Laboratory of Traditional Chinese Medicine Four Diagnostic Information, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Feng Cheng
- Department of Biostatistics and Epidemiology, College of Public Health, University of South Florida, Tampa, FL 33612, USA
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
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Huang J, Peng X, Dong K, Tao J, Yang Y. The Association Between Insulin Resistance, Leptin, and Resistin and Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients with Different Body Mass Indexes. Diabetes Metab Syndr Obes 2021; 14:2357-2365. [PMID: 34079314 PMCID: PMC8163637 DOI: 10.2147/dmso.s305054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/15/2021] [Indexed: 02/01/2023] Open
Abstract
AIM This study aimed to compare HOMA-IR, leptin, and resistin as the risk factors for diabetic nephropathy in the type 2 diabetes mellitus (T2DM) patients with different BMI classifications. MATERIALS AND METHODS A total of 309 patients with T2DM were enrolled in this cross-sectional study. All participants were divided into three groups according to BMI: the normal weight group (18.5 kg/m2≤BMI<24 kg/m2), the overweight group (24kg/m2≤BMI<28 kg/m2) and the obesity group (BMI≥28 kg/m2). The clinical information and laboratory examinations were recorded in detail. Leptin and resistin levels were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS Higher HOMA-IR, leptin and resistin levels were found to be the risk factors for diabetic nephropathy when we made comparisons in the total population (P<0.05). In the normal weight group, logistic regression analysis showed that T2DM patients with higher HOMA-IR (OR=4.210, P=0.001), leptin (OR=2.474, P=0.031) and resistin levels (OR=8.299, P<0.001) had nearly 4-fold, 2-fold and 8-fold risk for diabetic nephropathy, respectively, after adjustments. The receiver operating characteristic (ROC) curves indicated that the area under the curves (AUCs) of HOMA-IR and resistin were 0.699 (95% CI 0.617-0.772) and 0.790 (95% CI 0.715-0.854), respectively, which were significantly larger than the AUC of 0.5 (all P<0.001). However, no significant association was observed between HOMA-IR, leptin, and resistin and renal complications (all P>0.05) in the overweight and obesity groups in both logistic regression and AUC analysis. CONCLUSION Higher insulin resistance, leptin and resistin levels were observed as risk factors for diabetic nephropathy in T2DM patients with lower BMI. These were not obvious in the overweight and obese patients.
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Affiliation(s)
- Jiaojiao Huang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Xuemin Peng
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Kun Dong
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Jing Tao
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Yan Yang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
- Correspondence: Yan Yang Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, People’s Republic of ChinaTel +86-27-83663331Fax +86-27-83662883 Email
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Factors Associated with Brachial-Ankle Pulse Wave Velocity in an Apparently Healthy Chinese Population. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9795240. [PMID: 32775457 PMCID: PMC7396024 DOI: 10.1155/2020/9795240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/21/2020] [Accepted: 07/08/2020] [Indexed: 11/18/2022]
Abstract
Purpose To investigate the factors influencing brachial-ankle pulse wave velocity (baPWV) in an apparently healthy Chinese population, especially the associations between baPWV and indices of blood pressure (BP). Methods A total of 1123 participants with no history of hypertension were enrolled in this study, and the baPWV and BP of all four limbs were measured along with other covariates. Correlation analyses and multivariate linear regression models were used to identify factors associated with baPWV. Results A total of 1123 participants (male 43.3%, mean age: 58.4 ± 13.9 years) were included. The average baPWV was 14.87 ± 3.21 m/s, and no difference was found between the sexes. Age was positively correlated with baPWV (r = 0.65, p < 0.01), especially in females (r = 0.71 versus 0.56 in males). The correlation coefficient between age and baPWV increased markedly after the age of 65 years. In addition, the resting heart rate (RHR), waist-hip ratio, glomerular filtration rate, and plasma glucose level were significantly correlated with baPWV (r = 0.25, 0.22, -0.43, and 0.25, respectively; p < 0.01). BP parameters were highly positively correlated with baPWV, especially systolic BP (SBP) and pulse pressure (PP). Multivariate regression revealed that age, BP parameters, and RHR were independently correlated with baPWV (p < 0.01) after adjusting for confounding factors. The standardized coefficients of SBP were greater than those of PP, followed by diastolic BP (DBP). Conclusion BaPWV increased with age, especially after 65 years. Age, BP, and RHR were independent factors associated with baPWV. The effect of SBP on baPWV was more prominent than that of PP.
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Differences in longitudinal associations of cardiovascular risk factors with arterial stiffness and pressure wave reflection in middle-aged Japanese men. Hypertens Res 2020; 44:98-106. [PMID: 32724134 DOI: 10.1038/s41440-020-0523-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/01/2020] [Accepted: 06/16/2020] [Indexed: 12/18/2022]
Abstract
The present prospective observational study was conducted to examine the differences in longitudinal associations of the conventional risk factors for cardiovascular disease (CVD) with arterial stiffness and with abnormal pressure wave reflection using repeated measurement data. In 4016 healthy middle-aged (43 ± 9 years) Japanese men without CVD at baseline, the conventional risk factors for CVD, brachial-ankle pulse wave velocity (brachial-ankle PWV) and radial augmentation index (rAI) were measured annually over a 9-year period. Mixed-model linear regression analysis demonstrated a significant independent positive longitudinal association of the mean blood pressure with both the brachial-ankle PWV (estimate = 5.51, standard error = 0.30, P < 0.01) and the rAI (estimate = 0.19, standard error = 0.02, P < 0.01). On the other hand, the serum levels of glycohemoglobin, low-density lipoprotein cholesterol and triglycerides showed longitudinal associations only with the brachial-ankle PWV and not the rAI. In addition, while the radial AI was found to show a significant longitudinal association with the brachial-ankle PWV, the inverse association was not significant. In conclusion, the conventional risk factors for CVD showed heterogeneous longitudinal associations with arterial stiffness and/or abnormal pressure wave reflection. Elevated blood pressure showed independent longitudinal associations with both arterial stiffness (macrovascular damage) and abnormal pressure wave reflection, suggesting that BP is also longitudinally associated, at least in part, with microvascular damage. On the other hand, abnormal glucose metabolism and dyslipidemia showed independent longitudinal associations with only arterial stiffness (macrovascular damage).
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Sang Y, Wu X, Miao J, Cao M, Ruan L, Zhang C. Determinants of Brachial-Ankle Pulse Wave Velocity and Vascular Aging in Healthy Older Subjects. Med Sci Monit 2020; 26:e923112. [PMID: 32445331 PMCID: PMC7260998 DOI: 10.12659/msm.923112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Vascular aging is characterized by increasing arterial stiffness as measured by pulse wave velocity. The present study evaluated the factors influencing vascular aging in Chinese healthy older subjects. MATERIAL AND METHODS Disease- and treatment-free aged (≥60 years) participants were recruited from 2014 to 2019. Cardiometabolic risk factors and brachial-ankle pulse wave velocity (baPWV) were assessed. We defined healthy vascular aging (HVA) as the lowest 10% and early vascular aging (EVA) as the highest 10% of the baPWV distribution, after adjustment for age and blood pressure (BP). We fitted linear and logistic regression models to assess the determinants. RESULTS In all, 794 subjects (mean age 66.5±6.8 years, 71.0% male) were recruited; the 10th and 90th percentiles of baPWV were 1278 cm/s and 1955 cm/s, respectively. Age, BP, heart rate, and triglycerides were all positively associated with baPWV, whereas male subjects and body mass index (BMI) were negatively associated with baPWV. The number of participants diagnosed with either HVA or EVA was 80. Logistic regression models showed that sex, BMI, heart rate, and triglycerides were associated with HVA and EVA after adjustment for age, BP, and other confounding factors. CONCLUSIONS Male, high BMI, low heart rate, and low triglycerides are protective factors for vascular aging in the healthy aged population. Management of BMI, heart rate, triglycerides in a reasonable range may help to alleviate the vascular aging process.
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Affiliation(s)
- Yu Sang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Xiaofen Wu
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Jianping Miao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Ming Cao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
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