The values of cardio-ankle vascular and ankle-brachial indices in patients with carbohydrate metabolic disorders: The ESSE-RF study in the Kemerovo Region


Cite item

Full Text

Abstract

Aim. To investigate factors associated with pathological cardio-ankle vascular and ankle-brachial indices (CAVI and ABI) in patients with carbohydrate metabolic disorders (CMD). Subjects and methods. A cross-sectional study was conducted in the framework of the multicenter epidemiological study “Epidemiology of Cardiovascular Diseases and Their Risk Factors in the Russian Federation” (ESSE-RF) in March to October 2013. The standard ESSE-RF protocol was extended by an additional study of peripheral arterial stiffness, by estimating CAVI and ABI automatically. A sample of 1619 people was formed in several stages, in which 311 patients with type 2 diabetes mellitus and prediabetes were identified and divided into 3 groups: 1) 41 patients with pathological CAVI values (≥9.0); 2) 241 with normal CAVI (<9.0); 3) 29 with pathological ABI (<0.9). Results. In the population-based sample of patients with CMD, the pathological CAVI values (≥9.0) were detected in 14.5%, and the pathological ABI was in 9.3% of the examinees. Regression analysis showed that the pathological vascular indices (both CAVI and ABI) were significantly associated with increases in blood pressure (BP) and heart rate (HR), and a decrease in glomerular filtration rate. At the same time, only the pathological CAVI was associated with advancing age (odds ratio (OR), 1.111; 95% confidence interval (CI), 1.050-1.176; p < 0.001), visceral obesity (OR, 3.088; 95% CI, 1.001-10.495; p=0.038), smoking duration (OR, 1.093; 95% CI, 1.008-1.185; p=0.009), prior stroke (OR, 4.695; 95% CI, 1.408-15.658; p=0.018), and a need for insulin therapy (OR, 18.947; 95% CI, 1.902- 87.783; p=0.006). The pathological ABI was associated with male sex (OR, 2.227; 95% CI, 1.040-4.765; p=0.039), prior myocardial infarction (OR, 8.646; 95% CI, 2.174-34.378; p=0.005), obesity (OR, 2.439; 95% CI, 1.010-5.889; p=0.034); hyperglycemia (OR, 2.439; 95% CI, 1.010-5.889; p=0.034), hyperuricemia (OR, 4.009; 95% CI, 1.850-8.684; p=0.033), and increases in triglyceride levels (OR, 2.984; 95% CI, 1.376-6.470; p=0.004) and CAVI (OR, 1.193; 95% CI, 1.034-1.377; p=0.005). Conclusion. The pathological vascular indices CAVI and ABI are associated with different risk factors for cardiovascular events in a cohort of patients with CMD. The common factors associated with both CAVI and ABI are increases in blood pressure and HR and a reduction in glomerular filtration rate. The common factors associated with both CAVI and ABI are increases in blood pressure and HR and a reduction in glomerular filtration rate.

References

  1. Дедов И.И., Шестакова М.В. Феномен «метаболической памяти» в прогнозировании риска развития сосудистых осложнений при сахарном диабете. Терапевтический архив. 2015;10:4-10. doi: 10.17116/terarkh201587104-10
  2. Лаптев Д.Н. Повышение ригидности артериальной стенки у детей и подростков с сахарным диабетом 1 типа и автономной дисфункцией. Сахарный диабет. 2015;18.(1):94-100. doi:http://dx.doi.org/10.14341/DM2015194-100
  3. Дедов И.И., Шестакова М.В., Александров А.А. и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под редакцией И.И. Дедова, М.В. Шестаковой (6-й выпуск). Сахарныйдиабет. 2013;16(1S):7-9. doi: 10.14341/DM20131S1-121
  4. Олейников В.Э., Матросова И.Б., Сергацкая Н.В., Томашевская Ю.А. Диагностическая и клиническая значимость метода оценки артериальной жесткости — сердечно-лодыжечного сосудистого индекса. Терапевтический архив. 2010;9:68-72.
  5. Алиева А.С., Ротарь О.П., Конради А.О. Оценка субклинического поражения сосудов на популяционном уровне. Трансляционная медицина. 2014;2:26-34.
  6. Сумин А.Н., Щеглова А.В. Оценка сердечно-лодыжечного сосудистого индекса у пациентов с клиническими проявлениями атеросклероза. Атеросклероз. 2015;11(3):94-102.
  7. Chang LH, Lin HD, Kwok CF, Won JG, Chen HS, Chu CH, Hwu CM, Kuo CS, Jap TS, Shih KC, Lin LY. The combination of the ankle brachial index and brachial ankle pulse wave velocity exhibits a superior association with outcomes in diabetic patients. Intern Med. 2014;53(21):2425-2431.
  8. Сумин А.Н., Щеглова А.В., Баштанова Т.Б., Барбараш О.Л. Влияние патологического сердечно-лодыжечного сосудистого индекса на годовые результаты коронарного шунтирования у больных ишемической болезни сердца. Кардиоваскулярная терапия и профилактика. 2015;14(30):18-24. doi:http://dx.doi.org/10.15829/1728-8800-2015-3-18-24
  9. Российское кардиологическое общество. Российские рекомендации «Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза». Атеросклероз и дислипидемии. 2012;4:5-52.
  10. Kawada T, Andou T, Fukumitsu M. Relationship between cardio-ankle vascular index and components of metabolic syndrome in combination with sex and age. Diabetes Metab Syndr. 2014;8(4):242-244. doi: 10.1016/j.dsx.2014.09.023
  11. Hata K, Nakagawa T, Hasegawa M, Kitamura H, Hayashi T, Ogami A. Relationship between overtime work hours and cardio-ankle vascular index (CAVI): a cross-sectional study in Japan. J Occup Health. 2014;56(4):271-278.
  12. Dobsak P, Soska V, Sochor O, Jarkovsky J, Novakova M, Homolka M, Soucek M, Palanova P, Lopez-Jimenez F, Shirai K. Increased cardio-ankle vascular index in hyperlipidemic patients without diabetes or hypertension. J Atheroscler Thromb. 2015;22(3):272-283. doi: 10.5551/jat.24851
  13. Tanisawa K, Ito T, Sun X, Kawakami R, Oshima S, Gando Y, Cao ZB, Sakamoto S, Higuchi M. Cardiorespiratory Fitness is a Strong Predictor of the Cardio-ankle Vascular Index in Hypertensive Middle-aged and Elderly Japanese Men. J Atheroscler Thromb. 2015;22(4):379-389. doi:http://dx.doi.org/10.5551/jat.24851
  14. Сумин А.Н., Щеглова А.В., Осокина А.В., Федорова Н.В., Жучкова Е.А., Барбараш О.Л. Сердечно-лодыжечный сосудистый индекс и непосредственные результаты коронарного шунтирования у больных ИБС. Российский кардиологический журнал. 2015;1(117):78-84. doi: 10.15829/1560-4071-2015-01-78-8
  15. Tian G, Wei W, Zhang W, Zhang L, You H, Liu W, Sun Z, Wang X, Wu X. Increasing age associated with elevated cardio-ankle vascular index scores in patients with type 2 diabetes mellitus. J Int Med Res. 2013;41(2):435-444.
  16. Ibata J, Sasaki H, Hanabusa T, Wakasaki H, Furuta H, Nishi M, Akamizu T, Nanjo K. Increased arterial stiffness is closely associated with hyperglycemia and improved by glycemic control in diabetic patients. J Diabetes Investig. 2013;4(1):82-87.
  17. Wang H, Zhang T, Zhu W, Wu H, Yan S. Acute effects of continuous and interval low-intensity exercise on arterial stiffness in healthy young men. Eur J Appl Physiol. 2014;114(7):1385-1392.
  18. Gómez-Marcos MÁ, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Gómez-Sánchez L, Gomez-Sanchez M, Rodríguez-Sanchez E, Maderuelo-Fernandez JA, García-Ortiz L; LOD-DIABETES Group. Cardio-ankle vascular index is associated with cardiovascular target organ damage and vascular structure and function in patients with diabetes or metabolic syndrome, LOD-DIABETES study: a case series report. Cardiovasc Diabetol. 2015;14:7. doi: 10.1186/s12933-014-0167-y
  19. Shimizu Y, Nakazato M, Sekita T, Kadota K, Yamasaki H, Takamura N, Aoyagi K, Maeda T. Association of arterial stiffness and diabetes with triglycerides-to-HDL cholesterol ratio for Japanese men: the Nagasaki Islands Study. Atherosclerosis. 2013; 228(2):491-495. doi: 10.1016/j.atherosclerosis.2013.03.021
  20. Tanaka Y, Fukui M, Tanaka M, Fukuda Y, Mitsuhashi K, Okada H, Yamazaki M, Hasegawa G, Yoshioka K, Nakamura N. The inter-arm difference in systolic blood pressure is a novel risk marker for subclinical atherosclerosis in patients with type 2 diabetes. Hypertens Res. 2014;37(6):548-552. doi: 10.1038/hr.2014.30
  21. Чумакова Г.А., Веселовская Н.Г., Отт А.В., Гриценко О.В. Взаимосвязь эпикардиального ожирения и ряда метаболических факторов риска с индексом раcпространенности коронарного атеросклероза. Кардиоваскулярная терапия и профилактика. 2015;14(2):35-40. doi:http://dx.doi.org/10.15829/1728-8800-2015-2-35-40
  22. Singh PP, Abbott JD, Lombardero MS, Sutton-Tyrrell K, Woodhead G, Venkitachalam L, Tsapatsaris NP, Piemonte TC, Lago RM, Rutter MK, Nesto RW; Bypass Angioplasty Revascularization Investigation 2 Diabetes Study Group. The prevalence and predictors of an abnormal ankle-brachial index in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial. Diabetes Care. 2011;34(2):464-487. doi: 10.2337/dc10-1734
  23. Kim KJ, Lee BW, Kim HM, Shin JY, Kang ES, Cha BS, Lee EJ, Lim SK, Lee HC. Associations between cardio-ankle vascular index and microvascular complications in type 2 diabetes mellitus patients. J Atheroscler Thromb. 2011;18(4):328-336.
  24. Barone Gibbs B, Dobrosielski DA, Althouse AD, Stewart KJ.The effect of exercise training on ankle-brachial index in type 2 diabetes. Atherosclerosis. 2013;230(1):125-130. doi: 10.1016/j.atherosclerosis.2013.07.002
  25. McDermott MM, Kibbe M, Guralnik JM, Pearce WH, Tian L, Liao Y, Zhao L, Criqui MH. Comparative effectiveness study of self-directed walking exercise, lower extremity revascularization, and functional decline in peripheral artery disease. J Vasc Surg. 2013;57(4):990-996.e1. doi: 10.1016/j.jvs.2012.09.068
  26. Miyashita Y, Endo K, Saiki A, Ban N, Nagumo A, Yamaguchi T, Kawana H, Nagayama D, Ohira M, Oyama T, Shirai K. Effect of ezetimibe monotherapy on lipid metabolism and arterial stiffness assessed by cardio-ankle vascular index in type 2 diabetic patients. J Atheroscler Thromb. 2010;17(10):1070-1076.
  27. Miyashita Y, Saiki A, Endo K, Ban N, Yamaguchi T, Kawana H, Nagayama D, Ohira M, Oyama T, Shirai K. Effects of olmesartan, an angiotensin II receptor blocker, and amlodipine, a calcium channel blocker, on Cardio-Ankle Vascular Index (CAVI) in type 2 diabetic patients with hypertension. J Atheroscler Thromb. 2009;16(5):621-626.
  28. Shirai K, Saiki A, Nagayama D, Tatsuno I, Shimizu K, Takahashi M. The Role of Monitoring Arterial Stiffness with Cardio-Ankle Vascular Index in the Control of Lifestyle-Related Diseases. Pulse (Basel). 2015;3(2):118-133. doi: 10.1159/000431235

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2016 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies