Arterial Stiffness Is More Associated with Albuminuria than Decreased Glomerular Filtration Rate in Patients with Type 2 Diabetes Mellitus: The REBOUND Study

J Diabetes Res. 2017:2017:7047909. doi: 10.1155/2017/7047909. Epub 2017 Aug 16.

Abstract

Aim: The aim of this study was to evaluate the association between arterial stiffness and albuminuria and glomerular filtration rate (GFR) in patients with type 2 diabetes mellitus.

Methods: This multicenter cohort study analyzed 2613 patients with type 2 diabetes. Brachial-ankle pulse wave velocity (baPWV) was used as a noninvasive marker of arterial stiffness. Additionally, the patients were categorized into four groups according to their albumin-to-creatinine ratio (ACR, normoalbuminuria versus albuminuria) and estimated GFR (eGFR, <60 mL/min/1.73 m2 versus ≥60 mL/min/1.73 m2).

Results: A univariate analysis revealed that maximal baPWV was significantly associated with both the ACR (r = 0.297, P < 0.001) and eGFR (r = -0.220, P < 0.001). A multivariate analysis adjusted for significant clinical variables and eGFR showed that baPWV remained significantly correlated with the ACR (r = 0.150, P < 0.001). Also, baPWV was correlated positively with the ACR in patients with an eGFR ≥ 60 mL/min/1.73 m2 (r = 0.146, P < 0.001). However, baPWV was not correlated with eGFR after adjustment for significant clinical variables.

Conclusions: The present findings indicate that arterial stiffness is more associated with albuminuria than a decrease in GFR in patients with type 2 diabetes mellitus.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Albuminuria / complications*
  • Albuminuria / epidemiology
  • Albuminuria / physiopathology
  • Albuminuria / urine
  • Ankle Brachial Index
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / physiopathology*
  • Diabetic Angiopathies / urine
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / physiopathology*
  • Diabetic Nephropathies / urine
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney / physiopathology*
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Pulse Wave Analysis
  • Republic of Korea / epidemiology
  • Severity of Illness Index
  • Vascular Stiffness*