Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population
Background: Patients with diabetic kidney disease (DKD) are at increased risk for cardiovascular events but traditional risk factors do not fully explain this association. Evaluation of subclinical vascular disease might improve risk stratification and management of these patients. The aim of the st...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/7/1139 |
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| author | Christodoula Kourtidou Vasileios Rafailidis Garyfallia Varouktsi Efthimios Kanakis Vassilios Liakopoulos Timoleon-Achilleas Vyzantiadis Maria Stangou Smaragdi Marinaki Konstantinos Tziomalos |
| author_facet | Christodoula Kourtidou Vasileios Rafailidis Garyfallia Varouktsi Efthimios Kanakis Vassilios Liakopoulos Timoleon-Achilleas Vyzantiadis Maria Stangou Smaragdi Marinaki Konstantinos Tziomalos |
| author_sort | Christodoula Kourtidou |
| collection | DOAJ |
| description | Background: Patients with diabetic kidney disease (DKD) are at increased risk for cardiovascular events but traditional risk factors do not fully explain this association. Evaluation of subclinical vascular disease might improve risk stratification and management of these patients. The aim of the study was to compare the prevalence of markers of arterial stiffness, carotid atherosclerosis and peripheral arterial disease between patients with DKD and patients with type 2 diabetes mellitus (T2DM) and preserved kidney function. Methods: We prospectively enrolled patients with DKD and age- and gender-matched patients with T2DM but without DKD (estimated glomerular filtration rate < and ≥60 mL/min/1.73 m<sup>2</sup>, respectively). The presence of arterial stiffness was evaluated by measuring pulse wave velocity (PWV), augmentation index (AIx), AIx adjusted to a heart rate of 75 beats/min (AIx@75) and central systolic, diastolic, pulse and mean blood pressure. The presence of carotid atherosclerosis was evaluated by measuring carotid stenosis, carotid intima-media thickness and maximal plaque thickness. The presence of PAD was evaluated with the measurement of ankle-brachial index (ABI). Results: Forty patients with T2DM were included in the study (mean age 71.6 ± 8.9 years). The prevalence of cardiovascular risk factors was similar in patients with and without DKD. PWV was higher in the former (9.8 ± 5.5 and 6.6 ± 4.4 m/s, respectively; <i>p</i> < 0.05) and carotid stenosis of the left carotid artery was also greater in patients with DKD (36.5 ± 12.6 and 22.1 ± 17.2%, respectively; <i>p</i> < 0.05). Other markers of arterial stiffness and carotid atherosclerosis and ABI did not differ between patients with DKD and those without DKD. Conclusions: Patients with DKD appear to have more pronounced arterial stiffness and carotid atherosclerosis than patients with T2DM and preserved kidney function despite the similar prevalence of traditional cardiovascular risk factors in the two groups. Therefore, evaluating the presence of subclinical vascular disease in these patients could be a useful tool for the personalization of their management. |
| first_indexed | 2024-03-09T10:16:20Z |
| format | Article |
| id | doaj.art-616335f8fcae4810be595705c0b9b535 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T10:16:20Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-616335f8fcae4810be595705c0b9b5352023-12-01T22:20:46ZengMDPI AGJournal of Personalized Medicine2075-44262022-07-01127113910.3390/jpm12071139Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk PopulationChristodoula Kourtidou0Vasileios Rafailidis1Garyfallia Varouktsi2Efthimios Kanakis3Vassilios Liakopoulos4Timoleon-Achilleas Vyzantiadis5Maria Stangou6Smaragdi Marinaki7Konstantinos Tziomalos8First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi Street, 54636 Thessaloniki, GreeceDepartment of Radiology, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, GreeceDepartment of Nephrology, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, GreeceFirst Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi Street, 54636 Thessaloniki, GreeceDepartment of Nephrology, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, GreeceFirst Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceDepartment of Nephrology, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, GreeceDepartment of Nephrology and Renal Transplantation, Medical School, National and Kapodistrian University of Athens, Laiko Hospital, 11527 Athens, GreeceFirst Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi Street, 54636 Thessaloniki, GreeceBackground: Patients with diabetic kidney disease (DKD) are at increased risk for cardiovascular events but traditional risk factors do not fully explain this association. Evaluation of subclinical vascular disease might improve risk stratification and management of these patients. The aim of the study was to compare the prevalence of markers of arterial stiffness, carotid atherosclerosis and peripheral arterial disease between patients with DKD and patients with type 2 diabetes mellitus (T2DM) and preserved kidney function. Methods: We prospectively enrolled patients with DKD and age- and gender-matched patients with T2DM but without DKD (estimated glomerular filtration rate < and ≥60 mL/min/1.73 m<sup>2</sup>, respectively). The presence of arterial stiffness was evaluated by measuring pulse wave velocity (PWV), augmentation index (AIx), AIx adjusted to a heart rate of 75 beats/min (AIx@75) and central systolic, diastolic, pulse and mean blood pressure. The presence of carotid atherosclerosis was evaluated by measuring carotid stenosis, carotid intima-media thickness and maximal plaque thickness. The presence of PAD was evaluated with the measurement of ankle-brachial index (ABI). Results: Forty patients with T2DM were included in the study (mean age 71.6 ± 8.9 years). The prevalence of cardiovascular risk factors was similar in patients with and without DKD. PWV was higher in the former (9.8 ± 5.5 and 6.6 ± 4.4 m/s, respectively; <i>p</i> < 0.05) and carotid stenosis of the left carotid artery was also greater in patients with DKD (36.5 ± 12.6 and 22.1 ± 17.2%, respectively; <i>p</i> < 0.05). Other markers of arterial stiffness and carotid atherosclerosis and ABI did not differ between patients with DKD and those without DKD. Conclusions: Patients with DKD appear to have more pronounced arterial stiffness and carotid atherosclerosis than patients with T2DM and preserved kidney function despite the similar prevalence of traditional cardiovascular risk factors in the two groups. Therefore, evaluating the presence of subclinical vascular disease in these patients could be a useful tool for the personalization of their management.https://www.mdpi.com/2075-4426/12/7/1139type 2 diabetes mellitusdiabetic kidney diseasediabetic nephropathyarterial stiffnesspulse wave velocitycarotid atherosclerosis |
| spellingShingle | Christodoula Kourtidou Vasileios Rafailidis Garyfallia Varouktsi Efthimios Kanakis Vassilios Liakopoulos Timoleon-Achilleas Vyzantiadis Maria Stangou Smaragdi Marinaki Konstantinos Tziomalos Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population Journal of Personalized Medicine type 2 diabetes mellitus diabetic kidney disease diabetic nephropathy arterial stiffness pulse wave velocity carotid atherosclerosis |
| title | Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population |
| title_full | Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population |
| title_fullStr | Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population |
| title_full_unstemmed | Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population |
| title_short | Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population |
| title_sort | evaluation of subclinical vascular disease in diabetic kidney disease a tool for personalization of management of a high risk population |
| topic | type 2 diabetes mellitus diabetic kidney disease diabetic nephropathy arterial stiffness pulse wave velocity carotid atherosclerosis |
| url | https://www.mdpi.com/2075-4426/12/7/1139 |
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