Aortic Distensibility in Type 1 Diabetes
Aortic Distensibility in Type 1 Diabetes
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DOI：
10.2337/dc12-0393
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发表时间：
2013-08-01
期刊：
影响因子：
16.2
通讯作者：
Bluemke, David A.
中科院分区：
文献类型：
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作者：
Turkbey, Evrim B.;Redheuil, Alban;Bluemke, David A.
目的评价糖尿病控制与并发症试验(DCCT)/糖尿病干预与并发症流行病学(EDIC)研究中79名受试者长期血糖、传统心血管疾病(CVD)危险因素与升主动脉僵硬的关系。用磁共振成像测量升主动脉(AA)的硬度/扩张性。结果受试者的平均年龄为507岁(47%为女性，平均糖尿病病程为28年)。经过22年的随访，27%的参与者出现了心血管并发症。在调整了性别和队列后，AA扩张性随着年龄、平均收缩压、低密度脂蛋白和平均HBA(1c)的增加而降低(分别为每10年-26.3%，每10毫米汞SBP-11.0%，每10 mg/dL低密度脂蛋白-1.8%，每单位平均HBA(1c)-9.3%)。与无大量蛋白尿的患者相比，有大量蛋白尿的患者AA扩张性降低25%(P<；0.0001)。较低的AA扩张性还与较大的左心室质量/容量比值(-3.4%/0.1g/mL；P<；0.0001)相关。结论高血压、慢性高血糖和大量白蛋白尿对DCCT/EDIC队列中的1型糖尿病患者AA刚性有强烈的不良影响。
OBJECTIVETo evaluate the relationship between long-term glycemia, traditional cardiovascular disease (CVD) risk factors, and ascending aortic stiffness in type 1 diabetes.RESEARCH DESIGN AND METHODSEight hundred seventy-nine subjects in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study were evaluated. The stiffness/distensibility of the ascending thoracic aorta (AA) was measured with magnetic resonance imaging. Associations of AA distensibility and CVD risk factors, mean HbA(1c), and cardiovascular complications including macroalbuminuria were assessed using multivariate linear regression models.RESULTSThe mean age of the subjects was 50 7 years (47% women, mean diabetes duration of 28 years). Over 22 years of follow-up, 27% of participants had cardiovascular complications. After adjusting for gender and cohort, AA distensibility was lower with increasing age, mean systolic blood pressure, LDL, and HbA(1c) measured over an average of 22 years (-26.3% per 10 years, -11.0% per 10 mmHg SBP, -1.8% per 10 mg/dL of LDL, and -9.3% per unit mean HbA(1c) [%], respectively). Patients with macroalbuminuria had 25% lower AA distensibility compared with those without (P < 0.0001). Lower AA distensibility also was associated with greater ratio of left ventricular mass to volume (-3.4% per 0.1 g/mL; P < 0.0001).CONCLUSIONSOur findings indicate strong adverse effects of hypertension, chronic hyperglycemia and macroalbuminuria on AA stiffness in type 1 diabetes in the DCCT/EDIC cohort.