Is visceral adiposity a modifier for the impact of blood pressure on arterial stiffness and albuminuria in patients with type 2 diabetes?

被引：11

作者：

Bouchi, Ryotaro ^{[1
]}

Ohara, Norihiko ^{[1
]}

Asakawa, Masahiro ^{[1
]}

Nakano, Yujiro ^{[1
]}

Takeuchi, Takato ^{[1
]}

Murakami, Masanori ^{[1
]}

Sasahara, Yuriko ^{[1
]}

Numasawa, Mitsuyuki ^{[1
]}

Minami, Isao ^{[1
]}

Izumiyama, Hajime ^{[1
,2
]}

Hashimoto, Koshi ^{[1
,3
]}

Yoshimoto, Takanobu ^{[1
]}

Ogawa, Yoshihiro ^{[1
,4
]}

机构：

[1] Tokyo Med & Dent Univ, Grad Sch Med & Dent Sci, Dept Mol Endocrinol & Metab, Bunkyo Ku, 1-5-45 Yushima, Tokyo 1138510, Japan

[2] Tokyo Med & Dent Univ, Ctr Med Welf & Liaison Serv, Tokyo 1138510, Japan

[3] Tokyo Med & Dent Univ, Grad Sch Med & Dent Sci, Dept Preempt Med & Metab, Tokyo 1138510, Japan

[4] Japan Agcy Med Res & Dev, CREST, Tokyo, Japan

来源：

CARDIOVASCULAR DIABETOLOGY | 2016年 / 15卷

关键词：

Visceral adiposity; Blood pressure; Arterial stiffness; Albuminuria; Type; 2; diabetes; GLOMERULAR-FILTRATION-RATE; CORONARY-HEART-DISEASE; CHRONIC KIDNEY-DISEASE; PULSE-WAVE VELOCITY; CARDIOVASCULAR-DISEASE; RISK-FACTORS; INCIDENT HYPERTENSION; GENERAL-POPULATION; AORTIC STIFFNESS; FAT ACCUMULATION;

D O I：

10.1186/s12933-016-0335-3

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: We aimed to investigate whether visceral adiposity could modify the impact of blood pressure on arterial stiffness and albuminuria in patients with type 2 diabetes. Methods: This cross-sectional study examines the interaction of visceral adiposity with increased blood pressure on arterial stiffness and albuminuria. 638 patients with type 2 diabetes ( mean age 64 +/- 12 years; 40 % female) were enrolled. Visceral fat area (VFA, cm(2)) was assessed by a dual-impedance analyzer, whereby patients were divided into those with VFA < 100 (N = 341) and those with VFA >= 100 (N = 297). Albuminuria was measured in a single 24-h urine collection (UAE, mg/day) and brachial-ankle pulse wave velocity (ba-PWV, cm/s) was used for the assessment of arterial stiffening. Linear regression analyses were used to investigate the association of systolic blood pressure (SBP) and VFA with UAE and baPWV. Results: Patients with VFA >= 100 were significantly younger, had higher SBP, HbA1c, triglycerides, UAE, alanine aminotransferase, C-reactive protein and lower high-density lipoprotein and shorter duration of diabetes than those with VFA < 100. SBP was significantly and almost equivalently associated with ba-PWV both in VFA < 100 (standardized beta 0.224, p = 0.001) and VFA >= 100 (standardized beta 0.196, p = 0.004) patients in the multivariate regression analysis adjusting for covariates including age, gender, HbA1c, diabetic complications and the use of insulin and anti-hypertensive agents. By contrast, the association of SBP with UAE was stronger in patients with VFA >= 100 (standardized beta 0.263, p = 0.001) than that in patients with VFA < 100 (standardized beta 0.140, p = 0.080) in the multivariate regression model. In the whole cohort, the significant interaction between SBP and VFA on UAE (standardized beta 0.172, p = 0.040) but not on ba-PWV (standardized beta -0.008, p = 0.916) was observed. Conclusions: The effect of increased blood pressure on arterial stiffness is almost similar in type 2 diabetic patients with both low and high visceral adiposity, while its association with albuminuria is stronger in the latter.

引用

页数：8

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[1] Predictors of cardiovascular events in patients with type 2 diabetic nephropathy and hypertension: A case for albuminuria [J].