Factors associated with abnormal heart-ankle vascular index in patients with type 2 diabetes and prediabetes

Abstract

Aim. To identify the prevalence of abnormal cardio-ankle vascular index (CAVI) in patients with impaired glucose metabolism (IGM) and factors associated with CAVI. Materials and methods. The study was conducted within the 'Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of the Russian Federation' (ESSE-RF) study, a cross-sectional, multicenter trial. The random sample of adults, males and females aged 25-64 years, from Kemerovo region was included in this investigation of CAVI. CAVI was measured using the VaSeraVS-1000 vascular screening system (Japan). A total of 318 people with diabetes mellitus (DM) type 1 or 2, impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) were identified in the sample of 1,619 patients with IGM. Two patients with type 1 diabetes, 29 patients with ankle-brachial index (ABI) <0.9 and 5 patients with unknown CAVI were excluded from the analysis. The final sample of 282 patients with DM2 or prediabetes (IFG and IGT) was divided into the following two groups: 41 patients with CAVI ≥9.0 (pathological CAVI) and 241 patients with CAVI <9.0 (normal CAVI). Results. Pathological CAVI was detected in 14.5% of patients with DM2 or prediabetes. In univariate logistic regression, pathological CAVI was associated with increase in age, greater duration of smoking, previous stroke, presence of arterial hypertension (AH), receiving insulin therapy for DM2, visceral obesity, increased heart rate (HR), systolic and diastolic blood pressure (SBP and DBP) and decreased glomerular filtration rate (GFR). In multivariate analysis, age [odds ratio (OR) =1.077, p=0.012], SBP (OR=1.024, p=0.007), HR (OR=1.027, p=0.033), CKD-EPI GFR (OR=1.506, p=0.002) and insulin therapy for DM2 (OR=10.238, p=0.031) retained their significance. Conclusion. The predictors of pathological CAVI in patients with DM2 or prediabetes were identified. Evaluation of CAVI in this cohort allowed the identification of patients with increased risk of cardiovascular complications.