A Cross-Sectional Study of the Effects of Type 2 Diabetes and Other Cardiovascular Risk Factors on Structure and Function of Nonstenotic Arteries of the Lower Limb

Abstract Background: Normoalbuminuric diabetic kidney disease (NADKD) is a newly defined DKD, the clinical features and pathogenesis for which are still being understood. This study aimed to investigate the features and risk factors for NADKD in patients with type 2 diabetes mellitus (T2DM).Methods: A retrospective cross-sectional study was conducted. The related clinical and laboratory data of patients with T2DM hospitalized between August 2012 and January 2020 were collected for statistical analysis. We classified the patients with T2DM into four groups on the basis of the presence or absence of albuminuria and reduced estimated glomerular filtration rate (eGFR). Analysis of variance, the Kruskal–Wallis test, and the chi-square test were used to compare the groups. Binary logistic regression analyses with a forward stepwise method were performed to explore the risk factors for renal dysfunction in hospitalized patients with normoalbuminuric T2DM.Results: Among the 1620 patients evaluated, 500 (30.9%) had DKD, of which 9% had NADKD. The prevalence of stroke, cardiovascular events, carotid plaque, and peripheral arterial disease in NADKD was significantly higher than in a non-DKD control group (normoalbuminuric T2DM patients with eGFR of ≥60 ml/min/1.73 m2). Regression analyses revealed that three significant independent factors were associated with NADKD: age (OR = 1.089, confidence interval [CI] 95% [1.055−1.123], p < 0.001), previous use of renin−angiotensin system inhibitors (RASIs; OR = 2.330, CI 95% [1.212−4.481], p = 0.011), and glycated hemoglobin (HbA1c; OR = 0.839, CI 95% [0.716−0.983], p = 0.03). Conclusions: NADKD is mainly associated with macrovascular rather than microvascular complications. NADKD is more common in patients with normoalbuminuric T2DM with older age, previous use of RASIs, and good glycemic control.

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Abdominal aortic calcification is associated with morbidity of cardiovascular disease and Fib-4 index in type 2 diabetes: a retrospective cross-sectional study

10.21203/rs.3.rs-30719/v1 ◽

2020 ◽

Author(s):

Yu Togashi ◽

Jun Shirakawa ◽

Daisuke Miyashita ◽

Mayu Kyohara ◽

Tomoko Okuyama ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cross Sectional Study ◽

Abdominal Aortic Calcification ◽

Cross Sectional ◽

Abdominal Aortic ◽

Artery Disease

Abstract Background: Little is known about the association between abdominal aortic calcification (AAC) and the risk of cardiovascular disease (CVD) among patients with diabetes. This study evaluated the cross-sectional association between AAC and CVD morbidity in patients with type 2 diabetes. Methods: This retrospective cross-sectional study enrolled 285 inpatients with type 2 diabetes. The lateral view of an abdominal X-ray image obtained while each subject was in a standing position was examined, and the AAC score and AAC length, corresponding to the area of calcific deposits in the anterior and posterior aortic wall for the L1-4 and L1-5 regions, respectively, were measured. The associations between the AAC scores and lengths and the presence of coronary artery disease (CAD), cerebral infarction (CI), and peripheral artery disease (PAD) were then assessed. The correlation between the AAC grades and other clinical factors were also evaluated. Results: The degree of AAC was significantly correlated with a higher prevalence of CAD and CI but not PAD after adjustments for cardiovascular risk factors. The AAC score was inversely correlated with BMI, and both the AAC score and the AAC length were correlated with the Fib-4 index; these correlations persisted after adjustments for cardiovascular risk factors and BMI, although AAC was not associated with ultrasonography-diagnosed fatty liver. Conclusion: AAC is associated with CAD and CI morbidity in patients with type 2 diabetes. AAC grading also predicts the Fib-4 index, a hepatic fibrosis marker, suggesting a novel potential predictor of liver disease that is independent of cardiovascular risk factors and obesity.

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