Abstract 12919: 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
Background: Type 1 diabetes (T1D) is associated with reduced arterial distensibility but the role of long term glycemic control on aortic stiffness is unclear. The aim of this study is to examine the relationship of cardiovascular disease (CVD) risk factors to ascending aortic (AA) distensibility in T1D patients.
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). Approximately half had 1-5 years duration with no pre-existing microvascular complications (primary prevention cohort) and half had 1-15 years duration with minimal pre-existing complications (secondary cohort). 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) (Figure). A multivariate model adjusted for machine type, gender, age assessed risk factor effects on AA distensibility. 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. AA distensibility was 21% less (p<0.001) among smokers than non-smokers within the secondary cohort, with no difference within the primary cohort.
Conclusions: In a large cohort of T1D, age and blood pressure, elevated HbA1c levels, and nephropathy, but not lipids, were jointly associated with significantly lower AA distensibility. These findings indicate a strong role of hyperglycemia and macroalbuminuria on acceleration of aortic stiffness.
- © 2011 by American Heart Association, Inc.