Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools
Abstract Background Arterial stiffness is a potential biomarker for cardiovascular disease (CVD) risk in patients with type 1 diabetes (T1D). However, its relation with other CV risk evaluation tools in T1D has not been elucidated yet. This study aimed to evaluate arterial stiffness in T1D patients...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-06-01
|
| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-022-01537-1 |
| _version_ | 1818211712724107264 |
|---|---|
| author | Simon Helleputte Luc Van Bortel Francis Verbeke Jos Op ‘t Roodt Patrick Calders Bruno Lapauw Tine De Backer |
| author_facet | Simon Helleputte Luc Van Bortel Francis Verbeke Jos Op ‘t Roodt Patrick Calders Bruno Lapauw Tine De Backer |
| author_sort | Simon Helleputte |
| collection | DOAJ |
| description | Abstract Background Arterial stiffness is a potential biomarker for cardiovascular disease (CVD) risk in patients with type 1 diabetes (T1D). However, its relation with other CV risk evaluation tools in T1D has not been elucidated yet. This study aimed to evaluate arterial stiffness in T1D patients free from known CVD, and compare it to other CV risk evaluation tools used in T1D. Methods Cross-sectional study in adults with a T1D duration of at least 10 years and without established CVD. Patients were categorized in CVD risk groups based on 2019 European Society of Cardiology (ESC) guidelines, and the STENO T1D risk engine was used to estimate 10-year risk for CV events. Arterial stiffness was evaluated with carotid-femoral pulse wave velocity (cf-PWV). Coronary artery calcium (CAC) score was assessed and carotid ultrasound was performed. Ambulatory 24-h blood pressure and central hemodynamic parameters were evaluated. Data on renal function and diabetic kidney disease was retrieved. Results 54 patients (age: 46 ± 9.5 years; T1D duration: 27 ± 8.8 years) were included. One-fourth of patients showed prematurely increased aortic stiffness based on cf-PWV (24%). Cf-PWV was significantly associated with CAC score, carotid intima-media thickness, central hemodynamic parameters and diabetic kidney disease. Based on STENO, 20 patients (37%) were at low, 20 patients (37%) at moderate, and 14 patients (26%) at high 10-year risk for CV event. Cf-PWV was strongly associated with the STENO score (rs = + 0.81; R2 = 0.566, p < 0.001), increasing with each higher STENO group (p < 0.01). However, cf-PWV was not significantly different between the two CV risk groups (high versus very high) based on ESC criteria, and ESC criteria compared to STENO classified 10 patients more as having > 10% 10-year risk for CV events (n = 44/54; 81.5% versus n = 34/54; 63%). Conclusions This study demonstrated that a substantial proportion of long-standing T1D patients free from known CVD show premature arterial stiffening. Cf-PWV strongly associates with the STENO risk score for future CV events and with cardiovascular imaging and function outcomes, thereby illustrating the clinical importance of arterial stiffness. The data, however, also show considerable heterogeneity in CV risk and differences in risk categorisation between the STENO tool and ESC criteria.There is a need for refinement of CV risk classification in T1D, and future studies should investigate if evaluation of arterial stiffness should be implemented in T1D clinical practice and which patients benefit the most from its assessment. |
| first_indexed | 2024-12-12T05:36:52Z |
| format | Article |
| id | doaj.art-acc82e246ecc46f5a25c44aacc505d30 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-12T05:36:52Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-acc82e246ecc46f5a25c44aacc505d302022-12-22T00:36:07ZengBMCCardiovascular Diabetology1475-28402022-06-0121111010.1186/s12933-022-01537-1Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation toolsSimon Helleputte0Luc Van Bortel1Francis Verbeke2Jos Op ‘t Roodt3Patrick Calders4Bruno Lapauw5Tine De Backer6Faculty of Medicine and Health Sciences, Ghent UniversityUnit of Clinical Pharmacology, Department of Basic and Applied Medical Sciences, Ghent UniversityFaculty of Medicine and Health Sciences, Ghent UniversityMaastricht University Medical Centre (MUMC)Faculty of Medicine and Health Sciences, Ghent UniversityFaculty of Medicine and Health Sciences, Ghent UniversityFaculty of Medicine and Health Sciences, Ghent UniversityAbstract Background Arterial stiffness is a potential biomarker for cardiovascular disease (CVD) risk in patients with type 1 diabetes (T1D). However, its relation with other CV risk evaluation tools in T1D has not been elucidated yet. This study aimed to evaluate arterial stiffness in T1D patients free from known CVD, and compare it to other CV risk evaluation tools used in T1D. Methods Cross-sectional study in adults with a T1D duration of at least 10 years and without established CVD. Patients were categorized in CVD risk groups based on 2019 European Society of Cardiology (ESC) guidelines, and the STENO T1D risk engine was used to estimate 10-year risk for CV events. Arterial stiffness was evaluated with carotid-femoral pulse wave velocity (cf-PWV). Coronary artery calcium (CAC) score was assessed and carotid ultrasound was performed. Ambulatory 24-h blood pressure and central hemodynamic parameters were evaluated. Data on renal function and diabetic kidney disease was retrieved. Results 54 patients (age: 46 ± 9.5 years; T1D duration: 27 ± 8.8 years) were included. One-fourth of patients showed prematurely increased aortic stiffness based on cf-PWV (24%). Cf-PWV was significantly associated with CAC score, carotid intima-media thickness, central hemodynamic parameters and diabetic kidney disease. Based on STENO, 20 patients (37%) were at low, 20 patients (37%) at moderate, and 14 patients (26%) at high 10-year risk for CV event. Cf-PWV was strongly associated with the STENO score (rs = + 0.81; R2 = 0.566, p < 0.001), increasing with each higher STENO group (p < 0.01). However, cf-PWV was not significantly different between the two CV risk groups (high versus very high) based on ESC criteria, and ESC criteria compared to STENO classified 10 patients more as having > 10% 10-year risk for CV events (n = 44/54; 81.5% versus n = 34/54; 63%). Conclusions This study demonstrated that a substantial proportion of long-standing T1D patients free from known CVD show premature arterial stiffening. Cf-PWV strongly associates with the STENO risk score for future CV events and with cardiovascular imaging and function outcomes, thereby illustrating the clinical importance of arterial stiffness. The data, however, also show considerable heterogeneity in CV risk and differences in risk categorisation between the STENO tool and ESC criteria.There is a need for refinement of CV risk classification in T1D, and future studies should investigate if evaluation of arterial stiffness should be implemented in T1D clinical practice and which patients benefit the most from its assessment.https://doi.org/10.1186/s12933-022-01537-1Arterial StiffnessCardiovascular RiskESC guidelinesSTENO risk engineType 1 DiabetesPulse Wave Velocity |
| spellingShingle | Simon Helleputte Luc Van Bortel Francis Verbeke Jos Op ‘t Roodt Patrick Calders Bruno Lapauw Tine De Backer Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools Cardiovascular Diabetology Arterial Stiffness Cardiovascular Risk ESC guidelines STENO risk engine Type 1 Diabetes Pulse Wave Velocity |
| title | Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools |
| title_full | Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools |
| title_fullStr | Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools |
| title_full_unstemmed | Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools |
| title_short | Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools |
| title_sort | arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools |
| topic | Arterial Stiffness Cardiovascular Risk ESC guidelines STENO risk engine Type 1 Diabetes Pulse Wave Velocity |
| url | https://doi.org/10.1186/s12933-022-01537-1 |
| work_keys_str_mv | AT simonhelleputte arterialstiffnessinpatientswithtype1diabetesanditscomparisontocardiovascularriskevaluationtools AT lucvanbortel arterialstiffnessinpatientswithtype1diabetesanditscomparisontocardiovascularriskevaluationtools AT francisverbeke arterialstiffnessinpatientswithtype1diabetesanditscomparisontocardiovascularriskevaluationtools AT josoptroodt arterialstiffnessinpatientswithtype1diabetesanditscomparisontocardiovascularriskevaluationtools AT patrickcalders arterialstiffnessinpatientswithtype1diabetesanditscomparisontocardiovascularriskevaluationtools AT brunolapauw arterialstiffnessinpatientswithtype1diabetesanditscomparisontocardiovascularriskevaluationtools AT tinedebacker arterialstiffnessinpatientswithtype1diabetesanditscomparisontocardiovascularriskevaluationtools |