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《Preventive Medicine》 2018-01
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Effect of aortic pulse wave velocity on target organ damage among older patients with type 2 diabetes mellitus

XU Yan;LIU Wei-bo;CHEN Sai-jun;XIA hong-jian;CAI Ya-wei;Department of Geriatric Medicine,Ningbo NO.2 Hospital;  
Objective To evaluate the association between aortic arterial stiffness and target organ damage, including renal function decline and left ventricular diastolic dysfunction among elderly diabetic patients and to provide theoretical basis for early prevention and intervention. Methods Brachial-ankle-artery pulse wave velocity(ba PWV) reflecting aortic arterial stiffness was observed in 151 diabetic patients with(n=78) or without hypertension(n=73). Clinical data were collected, cardiac structure and function were assessed by echocardiography. Estimated glomerular filtration rate(e GFR) was calculated by CKD-EPI fomula. Results Of 151 subjects,the average age was(75.05±10.13) years and the average ba PWV values was(1 803.85±491.04) mm/s. Patients with both diabetes and hypertension had significantly higher ba PWV values [(2006.49±536.70) mm/s] than that of diabetic patients [(1596.96 ±331.02) mm/s, P 0.01]. Multiple linear regression analysis demonstrated that ba PWV was negatively associated with E/A ratio and e GFR(β'=-0.249,-0.225,P0.05),but positively associated with hypertension(β'=2.008,P0.05). By applying area under the receiver operator characteristic curve,ba PWV had powerful predictive power for renal impairment(AUC=0.695, 95% CI: 0.548-0.842) and left ventricular diastolic dysfunction(AUC=0.687,95%CI:0.532-0.842). Conclusion Patients with both diabetes and hypertension had significantly higher ba PWV values than that of diabetic patients. Higher ba PWV was independently associated with greater burden of sub-clinical disease in renal impairment and left ventricular diastolic dysfunction.
【Fund】: 浙江省预防医学会医防整合专项科研项目(2015ZJYF-A011);; 宁波市科技局社发项目(2014C50062)
【CateGory Index】: R587.1
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