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Arterial stiffness and subclinical atherosclerosis in the coronary arteries at different stages of dysglycaemia

Cederqvist, John ; Rådholm, Karin ; Muhammad, Iram Faqir LU ; Engström, Gunnar LU ; Engvall, Jan and Östgren, Carl Johan LU (2023) In Diabetic Medicine 40(7).
Abstract

Aim: Our aim was to investigate in a large population-based cohort study whether increased arterial stiffness and subclinical atherosclerosis in the coronary arteries differ at different stages of dysglycaemia. Methods: Data were obtained from SCAPIS, a population-based cohort of participants 50–64 years. The study population of 9379 participants was categorised according to glycaemic status: normoglycaemic, pre-diabetes (fasting glucose: 6.1–6.9 mmol/L and/or HbA1c 6%–6.4%) and diabetes. Pulse wave velocity (PWV) was measured by the SphygmoCor XCEL system and arterial stiffness was defined by PWV ≥10 m/s. Coronary artery calcium score (CACS) was assessed by coronary computed tomography and coronary artery calcification was defined by... (More)

Aim: Our aim was to investigate in a large population-based cohort study whether increased arterial stiffness and subclinical atherosclerosis in the coronary arteries differ at different stages of dysglycaemia. Methods: Data were obtained from SCAPIS, a population-based cohort of participants 50–64 years. The study population of 9379 participants was categorised according to glycaemic status: normoglycaemic, pre-diabetes (fasting glucose: 6.1–6.9 mmol/L and/or HbA1c 6%–6.4%) and diabetes. Pulse wave velocity (PWV) was measured by the SphygmoCor XCEL system and arterial stiffness was defined by PWV ≥10 m/s. Coronary artery calcium score (CACS) was assessed by coronary computed tomography and coronary artery calcification was defined by CACS ≥100. Results: We identified 1964 (21%) participants with dysglycaemia, out of which 742 (7.9%) had diabetes mellitus. PWV ≥10 m/s was present in 808 (11%), 191 (16%), 200 (27%) and CACS ≥100 in 801 (11%), 190 (16%), 191 (28%) participants with normoglycaemia, pre-diabetes and diabetes, respectively, all, p < 0.001. The overlap between PWV ≥10 m/s and CACS ≥100 within each glycaemic category was 188 (2.5%), 44 (3.6%) and 77 (10) respectively. There was an association between glycaemic status and increased PWV in the fully adjusted models, but not for glycaemic status and CACS ≥100, where there was no difference for pre-diabetes compared to normoglycaemia, OR 1.2 (95% CI 0.98–1.4). In the total study population, there was an association between HbA1c and PWV after adjustment, p < 0.001. Conclusions: Our results show that increased arterial stiffness and subclinical coronary artery atherosclerosis are present in the early stages of dysglycaemia, but the overlap between markers of major subclinical vascular damage was small in all glycaemic categories. This could be explained by different pathways in the pathogenesis of arterial stiffness or atherosclerosis in the coronary arteries.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
arterial stiffness, coronary artery calcium score, pre-diabetes, pulse wave velocity
in
Diabetic Medicine
volume
40
issue
7
article number
e15102
publisher
Wiley-Blackwell
external identifiers
  • pmid:37004152
  • scopus:85152258718
ISSN
0742-3071
DOI
10.1111/dme.15102
language
English
LU publication?
yes
id
75463b2c-6223-411a-9b68-13ddb5e23e9b
date added to LUP
2023-07-20 11:55:31
date last changed
2024-04-19 23:50:02
@article{75463b2c-6223-411a-9b68-13ddb5e23e9b,
  abstract     = {{<p>Aim: Our aim was to investigate in a large population-based cohort study whether increased arterial stiffness and subclinical atherosclerosis in the coronary arteries differ at different stages of dysglycaemia. Methods: Data were obtained from SCAPIS, a population-based cohort of participants 50–64 years. The study population of 9379 participants was categorised according to glycaemic status: normoglycaemic, pre-diabetes (fasting glucose: 6.1–6.9 mmol/L and/or HbA1c 6%–6.4%) and diabetes. Pulse wave velocity (PWV) was measured by the SphygmoCor XCEL system and arterial stiffness was defined by PWV ≥10 m/s. Coronary artery calcium score (CACS) was assessed by coronary computed tomography and coronary artery calcification was defined by CACS ≥100. Results: We identified 1964 (21%) participants with dysglycaemia, out of which 742 (7.9%) had diabetes mellitus. PWV ≥10 m/s was present in 808 (11%), 191 (16%), 200 (27%) and CACS ≥100 in 801 (11%), 190 (16%), 191 (28%) participants with normoglycaemia, pre-diabetes and diabetes, respectively, all, p &lt; 0.001. The overlap between PWV ≥10 m/s and CACS ≥100 within each glycaemic category was 188 (2.5%), 44 (3.6%) and 77 (10) respectively. There was an association between glycaemic status and increased PWV in the fully adjusted models, but not for glycaemic status and CACS ≥100, where there was no difference for pre-diabetes compared to normoglycaemia, OR 1.2 (95% CI 0.98–1.4). In the total study population, there was an association between HbA1c and PWV after adjustment, p &lt; 0.001. Conclusions: Our results show that increased arterial stiffness and subclinical coronary artery atherosclerosis are present in the early stages of dysglycaemia, but the overlap between markers of major subclinical vascular damage was small in all glycaemic categories. This could be explained by different pathways in the pathogenesis of arterial stiffness or atherosclerosis in the coronary arteries.</p>}},
  author       = {{Cederqvist, John and Rådholm, Karin and Muhammad, Iram Faqir and Engström, Gunnar and Engvall, Jan and Östgren, Carl Johan}},
  issn         = {{0742-3071}},
  keywords     = {{arterial stiffness; coronary artery calcium score; pre-diabetes; pulse wave velocity}},
  language     = {{eng}},
  number       = {{7}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Diabetic Medicine}},
  title        = {{Arterial stiffness and subclinical atherosclerosis in the coronary arteries at different stages of dysglycaemia}},
  url          = {{http://dx.doi.org/10.1111/dme.15102}},
  doi          = {{10.1111/dme.15102}},
  volume       = {{40}},
  year         = {{2023}},
}