Arterial Stiffness is Related to Diabetes-Associated Microvascular Complications: the SEARCH for Diabetes in Youth Study
Objective: To assess the relationship between arterial stiffness, an early marker of macrovascular cardiovascular disease, and microvascular complications in adolescents and young adults with youth-onset diabetes. Research Design and Methods: This study included 1226 individuals (median age initial visit 18 years, 58% female, 53% Non-Hispanic White, 22% Non-Hispanic Black, 20% Hispanic) with youth-onset type 1 or type 2 diabetes from the SEARCH for Diabetes in Youth Study. Arterial stiffness measures included pulse wave velocity for carotid-femoral (PWVcf), carotid-radial (PWVcr), femoral-foot (PWVff) and augmentation index (AIx). Microvascular complications included microalbuminuria, peripheral neuropathy, and retinopathy. Participants were followed up once at approximately 5 years. Results: Cross-sectionally, in type 1 diabetes, AIx was associated with higher odds of having any one microvascular complication (OR 1.35, 95% CI 1.04-1.76), microalbuminuria (OR 2.76, 95% CI 1.78-4.39), neuropathy (OR 1.63, 95% CI 1.07-2.50), and retinopathy (OR 1.37, 95% CI 1.06-1.79). In type 2 diabetes, AIx was associated with higher odds of microalbuminuria (OR 2.05, 95% CI 1.04-4.33), all p<0.05. In longitudinal analysis, in type 1 diabetes, a change in AIx was associated with the development of any one microvascular complication (OR 1.45, 95% CI 1.15-1.82), microalbuminuria (OR 5.42, 95% CI 1.98-14.80), neuropathy (OR 2.03, 95% CI 1.22-3.40), and retinopathy (OR 1.48, 95% CI 1.15-1.90). In type 2 diabetes, a change in AIx was associated with development of microalbuminuria (OR 21.98, 95% CI 1.30-372.88) (all p<0.05). Conclusions: Arterial stiffness is related to and predicts microvascular complications in youth-onset type 1 and type 2 diabetes.
