The Influencing Factors Of Brachial-Ankle Pulse Wave Velocity In Patients With Diabetes

Objective: To retrospectively analyze the influencing factors of brachial-ankle pulse wave velocity(baPWV)in patients with diabetes.Methods: Collected clinical data of outpatients or inpatients with diabetes from Fujian Medical University Union Hospital from January 1,2019 to August 31,2019,including demographic characteristics,blood test indicators,arterial elasticity indicators,hemodynamic parameters,ultrasound cardiogram parameters and cervical vascular ultrasound parameters.Body mass index(BMI)was calculated from height and weight.The estimated glomerular filtration rate(eGFR)was calculated using CKD-EPI formula.BaPWV,heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)were measured by BP203RPE-Ⅱ(VP-1000)(OMRON,Japan).Ascending aorta(AO)and other UCG parameters was measured using echocardiography.Common carotid artery diameter was measured using cervical vascular ultrasound.According to the baPWV value,patients were divided into normal baPWV group(baPWV<1400cm/s,vascular aging group)and elevated baPWV group(baPWV ≥1400cm/s,non-vascular aging group).The clinical baseline data of the two groups were compared.Multiple stepwise regression analysis was used to evaluate the factors affecting baPWV.Results: 760 patients were enrolled in the study,230 cases of them in the normal baPWV group and 530 cases of them in the elevated baPWV group.Age,waist circumference,visceral adipose tissue(VAT),γ-glutamyl transpeptidase(γ-GT),urea,creatinine,triacylglycerol(TG),hypersensitive C-reactive protein(hs-CRP),HR,SBP,mean arterial pressure(MAP),DBP,pulse pressure(PP),left atrium inner diameter(LAD),AO,left ventricle posterior wall thickness(LVPW),interventricular septal thickness(IVS),right ventricular outflow tract diameter(RVOD),left ventricular mass(LVM),left ventricular mass index(LVMI),E / E ’,pulmonary artery systolic pressure,common carotid artery diameter and carotid intima-media thickness(c IMT)in the elevated baPWV group were higher than those in the normal baPWV group(P <0.05).The eGFR and E / A were lower in the elevated baPWV group than those in the normal baPWV group(P <0.05).BMI,fasting blood glucose,total cholesterol(TC),high-density lipoprotein cholesterol(HDLc),low-density lipoprotein cholesterol(LDLc),and left ventricular ejection fraction(LVEF)were no significant differences between the two groups(P> 0.05).After being adjusted for other factors with multivariate stepwise regression analysis,age,BMI,HR,SBP,DBP and common carotid artery diameter were associated with baPWV independently.Conclusions: The main factors to influent baPWV in patients with diabetes are age,BMI,heart rate,systolic blood pressure,diastolic blood pressure and common carotid artery diameter,which provides a theoretical basis for improving arterial stiffness in diabetes.