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DC22-1703 Urbina_AS_CAN_HRV_Search_supplemental_tables_final_clean.docx (38.12 kB)

Association of Elevated Arterial Stiffness with Cardiac Target Organ Damage and Cardiac Autonomic Neuropathy in Young Adults with Diabetes: The SEARCH for Diabetes in Youth Study

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posted on 2023-02-02, 19:42 authored by Elaine M. Urbina, Scott Isom, Dana Dabelea, Ralph D’Agostino, Jr., Stephen R. Daniels, Lawrence M. Dolan, Giuseppina Imperatore, Eva Lustigova, Santica Marcovina, Amy Mottl, Catherine Pihoker, Amy S Shah

  

Background: Adults with diabetes are at risk of cardiovascular (CV) events, possibly due to increased arterial stiffness (AS) and cardiac autonomic neuropathy (CAN). We sought to determine if 1) AS is associated with cardiac target organ damage in young adults with youth-onset diabetes, 2) whether CAN is associated with AS, as one possible etiology for increased AS in this cohort, and 3) whether these relationships differed by type of diabetes. 

Methods: Participants from the SEARCH for Diabetes in Youth Study (type 1 diabetes mellitus, T1D = 222, type 2 diabetes mellitus, T2D = 177, mean 23 years) had clinical, echocardiographic, AS and CAN assessed.  Linear regression was performed to determine if AS was associated with cardiac changes and CAN and if relationships differed by diabetes type.   

Results: AS was significantly associated with cardiac structure (left ventricular mass index, p<0.0001), systolic function (ejection fraction, p=0.03) and diastolic function (E/A ratio, p=0.008; e’/a’, p=0.02) after adjustments for CV risk factors. The association between AS and CAN was not significant when other important covariates were added. These relationships were mostly similar in both T1D and T2D. 

Conclusions: AS is associated with cardiac changes in young adults with diabetes. CAN-induced AS does not appear to be an etiology for cardiac abnormalities in this cohort. 

Funding

Barbara Davis Center at the University of Colorado at Denver

U.S. Department of Health and Human Services > Centers for Disease Control and Prevention 00097 DP-05-069 DP-10-001

Clinical & Translational Research Institute

Clinical Research Center

Kaiser Foundation Health Plan

Kaiser Permanente Southern California

U.S. Department of Health and Human Services > National Institutes of Health > National Institute of Diabetes and Digestive and Kidney Diseases

National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases x 1R01DK127208-01 1UC4DK108173

NIH/NCATS x UL1 TR00423

Seattle Children's Hospital

Southern California Permanente Medical Group

the Medical University of South Carolina, NIH/National Center for Advancing Translational Sciences (NCATS) x UL1 TR000062

the University of Cincinnati, NIH/NCATS x UL1 TR000077 UL1 TR001425

University of Colorado Pediatric Clinical and Translational Research Center, NIH/NCATS x UL1 TR000154

University of Washington

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