Document Detail

Aortic pulse wave velocity and albuminuria in patients with type 2 diabetes.
MedLine Citation:
PMID:  15743996     Owner:  NLM     Status:  MEDLINE    
Development of microalbuminuria increases the risk for cardiovascular disease (CVD) in type 2 diabetes. The nature of this relationship is unclear but may involve arterial stiffness, an independent risk marker for CVD mortality. Aortic pulse wave velocity (Ao-PWV) and albumin creatinine ratio (ACR) were measured in 134 consecutive patients with type 2 diabetes without overt renal impairment (serum creatinine <150 micromol/L). ACR ranged from 0.2 to 153 mg/mmol. Patients with raised ACR (>/=3 mg/mmol) had higher Ao-PWV, poorer diabetic control, and higher pulse pressure (PP) and systolic BP (SBP) (all P < 0.05) than those with normal ACR. The closest univariate associations of Ao-PWV were positively with age, duration of diabetes, SBP, PP, ACR, and insulin treatment and negatively with GFR and weight (all P < 0.01). In a multiple linear step-down regression analysis, the significant predictors of Ao-PWV were age, SBP or PP, duration of diabetes, gender, number of antihypertensive medications, and use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, which together explained 55% of the variance of Ao-PWV. When ACR was offered in place of arterial pressure to a separate model, ACR emerged as a significant predictor of Ao-PWV. After age adjustment, patients with lower, below median GFR had higher Ao-PWV than those with GFR above the median (P = 0.043). In patients with type 2 diabetes without overt renal impairment, raised ACR is associated with higher Ao-PWV, a relationship most likely mediated by raised BP. The association of Ao-PWV with reduced GFR suggests that even modest renal dysfunction may affect the viscoelastic properties of large arteries.
Andrew Smith; Janaka Karalliedde; Lorenita De Angelis; David Goldsmith; Giancarlo Viberti
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-03-02
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  16     ISSN:  1046-6673     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-24     Completed Date:  2005-09-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1069-75     Citation Subset:  IM    
Unit for Metabolic Medicine, 5th Floor, Department of Diabetes and Endocrinology, Cardiovascular Division, GKT School of Medicine, King's College London, Guy's Hospital, St. Thomas Street, London SE1 9RT, UK.
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MeSH Terms
Albuminuria / etiology*
Antihypertensive Agents / therapeutic use
Aorta / physiopathology*
Blood Flow Velocity*
Blood Pressure
Creatinine / blood,  urine
Diabetes Mellitus, Type 2 / complications*,  physiopathology*
Glomerular Filtration Rate
Linear Models
Middle Aged
Sex Factors
Time Factors
Reg. No./Substance:
0/Antihypertensive Agents; 60-27-5/Creatinine

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