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Gender differences in the progression of target organ damage in patients with increased insulin resistance: the LOD-DIABETES study.

Gómez-Marcos MÁ, Recio-Rodríguez JI, Gómez-Sánchez L, Agudo-Conde C, Rodríguez-Sanchez E, Maderuelo-Fernandez J, Gomez-Sanchez M, García-Ortiz L, LOD-DIABETES Gro - Cardiovasc Diabetol (2015)

Bottom Line: HbA1c was positively associated with PWV (β = 0.501; p = 0.014).The PWV increase showed a positive association with mean HbA1c levels during the follow-up.Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. magomez@usal.es.

ABSTRACT

Background: The purpose of this study was to analyze the evolution of vascular, cardiac and renal target organ damage (TOD) in patients with increased insulin resistance over a 3.5 year follow-up and to investigate gender difference and factors that influence its progression.

Methods: We performed a prospective observational study involving 112 patients (71 men, 41 women) who were followed for 3.5 years. Measurements included blood pressure, blood glucose, lipids, smoking, body mass index (BMI) and HOMA-Ir Vascular TOD included carotid intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index (ABI). Cardiac TOD included Cornell voltage-duration product and Sokolow. Renal TOD included creatinine, glomerular filtration and albumin/creatinine ratio.

Results: The IMT increased in both genders. Each year, the IMT increased 0.005 mm in men and 0.011 in women and the PWV 0.024 and 0.020 m/sec, respectively. The highest increase was in women with type 2 diabetes mellitus, who had an increase in TOD carotid (40%), PWV (24%) and renal TOD (20 %). Multiple regression analysis, after adjusting for age and gender, showed a negative association between duration since diabetes diagnosis and ABI (β = -0.006; p = 0.017) and between BMI and glomerular filtration (β = -0.813; p = 0.014). HbA1c was positively associated with PWV (β = 0.501; p = 0.014).

Conclusions: This study showed that the progression of vascular and renal TOD differs by gender. The increase in vascular and renal TOD was higher in women, especially in diabetic women. The PWV increase showed a positive association with mean HbA1c levels during the follow-up. Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis.

Trial registration: Clinical Trials.gov Identifier NCT01065155.

No MeSH data available.


Related in: MedlinePlus

Changes in target organ damage over time during 3.5 years of follow-up. a Target organ damage (TOD) in men and in women; b Vascular TOD in men and in women. IMT intima media thickness, cf-PWV carotid femoral pulse wave velocity, ABI ankle brachial index. In men, the vascular TOD was significantly different between the final and baseline assessment and the 2nd and 3rd assessments (p < 0.05). The cf-PWV TOD was also significantly different between the final and baseline assessment (p < 0.05). In women, the vascular TOD was significantly different between the 2nd and 3rd assessments (p < 0.05). There was also a significant difference in the IMT TOD between the baseline and 2nd assessment and between the 2nd and 3rd assessment (p < 0.05). The cf-PWV TOD was significantly different between the 2nd and 3rd assessment (p < 0.05)
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Fig2: Changes in target organ damage over time during 3.5 years of follow-up. a Target organ damage (TOD) in men and in women; b Vascular TOD in men and in women. IMT intima media thickness, cf-PWV carotid femoral pulse wave velocity, ABI ankle brachial index. In men, the vascular TOD was significantly different between the final and baseline assessment and the 2nd and 3rd assessments (p < 0.05). The cf-PWV TOD was also significantly different between the final and baseline assessment (p < 0.05). In women, the vascular TOD was significantly different between the 2nd and 3rd assessments (p < 0.05). There was also a significant difference in the IMT TOD between the baseline and 2nd assessment and between the 2nd and 3rd assessment (p < 0.05). The cf-PWV TOD was significantly different between the 2nd and 3rd assessment (p < 0.05)

Mentions: Figure 2 shows the trend and the percentage of participants, by gender, who had vascular, cardiac and renal TOD at each of the four time points. The overall TOD increased in men and women by 10 and 17 %, respectively. In men and women, the overall vascular TOD increased by 11.5 and 14 %, the overall renal TOD increased by −8 and 7 %, and the overall cardiac TOD increased by 1.5 and 5 %, respectively.Fig. 2


Gender differences in the progression of target organ damage in patients with increased insulin resistance: the LOD-DIABETES study.

Gómez-Marcos MÁ, Recio-Rodríguez JI, Gómez-Sánchez L, Agudo-Conde C, Rodríguez-Sanchez E, Maderuelo-Fernandez J, Gomez-Sanchez M, García-Ortiz L, LOD-DIABETES Gro - Cardiovasc Diabetol (2015)

Changes in target organ damage over time during 3.5 years of follow-up. a Target organ damage (TOD) in men and in women; b Vascular TOD in men and in women. IMT intima media thickness, cf-PWV carotid femoral pulse wave velocity, ABI ankle brachial index. In men, the vascular TOD was significantly different between the final and baseline assessment and the 2nd and 3rd assessments (p < 0.05). The cf-PWV TOD was also significantly different between the final and baseline assessment (p < 0.05). In women, the vascular TOD was significantly different between the 2nd and 3rd assessments (p < 0.05). There was also a significant difference in the IMT TOD between the baseline and 2nd assessment and between the 2nd and 3rd assessment (p < 0.05). The cf-PWV TOD was significantly different between the 2nd and 3rd assessment (p < 0.05)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4591592&req=5

Fig2: Changes in target organ damage over time during 3.5 years of follow-up. a Target organ damage (TOD) in men and in women; b Vascular TOD in men and in women. IMT intima media thickness, cf-PWV carotid femoral pulse wave velocity, ABI ankle brachial index. In men, the vascular TOD was significantly different between the final and baseline assessment and the 2nd and 3rd assessments (p < 0.05). The cf-PWV TOD was also significantly different between the final and baseline assessment (p < 0.05). In women, the vascular TOD was significantly different between the 2nd and 3rd assessments (p < 0.05). There was also a significant difference in the IMT TOD between the baseline and 2nd assessment and between the 2nd and 3rd assessment (p < 0.05). The cf-PWV TOD was significantly different between the 2nd and 3rd assessment (p < 0.05)
Mentions: Figure 2 shows the trend and the percentage of participants, by gender, who had vascular, cardiac and renal TOD at each of the four time points. The overall TOD increased in men and women by 10 and 17 %, respectively. In men and women, the overall vascular TOD increased by 11.5 and 14 %, the overall renal TOD increased by −8 and 7 %, and the overall cardiac TOD increased by 1.5 and 5 %, respectively.Fig. 2

Bottom Line: HbA1c was positively associated with PWV (β = 0.501; p = 0.014).The PWV increase showed a positive association with mean HbA1c levels during the follow-up.Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. magomez@usal.es.

ABSTRACT

Background: The purpose of this study was to analyze the evolution of vascular, cardiac and renal target organ damage (TOD) in patients with increased insulin resistance over a 3.5 year follow-up and to investigate gender difference and factors that influence its progression.

Methods: We performed a prospective observational study involving 112 patients (71 men, 41 women) who were followed for 3.5 years. Measurements included blood pressure, blood glucose, lipids, smoking, body mass index (BMI) and HOMA-Ir Vascular TOD included carotid intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index (ABI). Cardiac TOD included Cornell voltage-duration product and Sokolow. Renal TOD included creatinine, glomerular filtration and albumin/creatinine ratio.

Results: The IMT increased in both genders. Each year, the IMT increased 0.005 mm in men and 0.011 in women and the PWV 0.024 and 0.020 m/sec, respectively. The highest increase was in women with type 2 diabetes mellitus, who had an increase in TOD carotid (40%), PWV (24%) and renal TOD (20 %). Multiple regression analysis, after adjusting for age and gender, showed a negative association between duration since diabetes diagnosis and ABI (β = -0.006; p = 0.017) and between BMI and glomerular filtration (β = -0.813; p = 0.014). HbA1c was positively associated with PWV (β = 0.501; p = 0.014).

Conclusions: This study showed that the progression of vascular and renal TOD differs by gender. The increase in vascular and renal TOD was higher in women, especially in diabetic women. The PWV increase showed a positive association with mean HbA1c levels during the follow-up. Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis.

Trial registration: Clinical Trials.gov Identifier NCT01065155.

No MeSH data available.


Related in: MedlinePlus