Relationship of aortic distensibility to cardiovascular disease risk factors in type 1 diabetes mellitus: the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study

Wednesday, October 26, 2011 — Poster Session III
10:00 a.m. – Noon	Natcher Conference Center	CC	IMAG-35

Authors

• EB Turkbey
• JC Backlund
• A Small
• A Redheuil
• PA Cleary
• JM Lachin
• RA Noureldin
• M Nacif
• N Kawel
• A Zavodni
• JA Lima
• DA Bluemke

Abstract

BACKGROUND: Type 1 diabetes (T1D) is associated with reduced arterial distensibility but the role of long term glycemic control on aortic stiffness is unclear. METHODS: 879 subjects of DCCT/EDIC study who had been followed for 22 yrs had cardiac MRI with phase contrast cine images of AA (mean age 50 years; 47 % female, mean diabetes duration: 28 years). Associations of CVD risk factors, including mean HbA1c and macroalbuminuria (albumin excretion rate > 300 mg/24hr or end-stage renal disease), with the natural log of AA distensibility were assessed using multivariate regression models. RESULTS: AA distensibility decreased by 3% per one year increase in age for both genders (p<0.0001). Mean systolic blood pressure and HbA1c levels measured over an average of 22 yrs were inversely associated with AA distensibility (-8.4% change per 10 mmHg and -6.2% change per unit mean HbA1c (%), respectively), but not lipids. AA distensibility was significantly lower by 14.3% (p=0.004) among patients with versus without macroalbuminuria. CONCLUSIONS: In a large cohort of T1D, age and blood pressure, elevated HbA1c levels, and nephropathy were jointly associated with significantly lower AA distensibility. These findings indicate a strong role of hyperglycemia and macroalbuminuria on acceleration of aortic stiffness.

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