Insulin resistance linked to arterial stiffness in type 1 diabetes
medwireNews: Researchers have identified an association between insulin resistance (IR) and arterial stiffness among people with type 1 diabetes.
Speaking at the virtual 57th EASD Annual Meeting, Gemma Llauradó (Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain) explained that while “insulin deficiency is the main pathogenic factor in type 1 diabetes,” people with the disease can also have clinical features of IR, in a condition termed “double diabetes.”
She added that the presence of IR is associated with an elevated risk for micro- and macrovascular complications in people with type 1 diabetes.
To investigate the hypothesis that IR in the arterial wall could promote arterial stiffness “through several mechanisms,” including vasoconstriction, inflammation, and oxidative stress, the team analyzed data from 179 adults with type 1 diabetes and no prior cardiovascular disease. The study cohort was categorized into quartiles based on IR, which was measured by the estimated glucose disposal rate (eGDR).
Llauradó reported that there was a significant trend for the association between IR and arterial stiffness as measured by average aortic pulse wave velocity (aPWV), with a correlation coefficient of 0.59. People in the lowest quartile of eGDR (<6.1 mg/kg per min) – indicating the highest level of IR – had the greatest degree of arterial stiffness, with an aPWV of 8.3 m/s. This decreased with increasing quartiles of eGDR, to 6.1 m/s for the highest quartile (>10 mg/kg per min).
In a multivariate analysis using the highest eGDR quartile as the reference group, people in the lowest two quartiles had significantly greater aPWV, indicating greater arterial stiffness, after adjustment for traditional cardiovascular risk factors including age, sex, diabetes duration, and dyslipidemia.
“Thus, insulin resistance [is] one of the main independent factors associated with increase of arterial stiffness,” said Llauradó.
She said that the key variable explaining this association “seemed to be abdominal obesity instead of glycemic control or hypertension.” Indeed, when components of the equation used to calculate eGDR were analyzed separately in the multivariate analysis, only waist-to-hip ratio was significantly associated with aPWV.
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