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Yonsei Med J. 2017 Jan;58(1):75-81. doi: 10.3349/ymj.2017.58.1.75.

The Impact of Diabetes Mellitus on Vascular Biomarkers in Patients with End-Stage Renal Disease.

Author information

1
Cardiology Division, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
2
Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
3
Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. yoosy0316@yuhs.ac.
4
Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. shpark0530@yuhs.ac.

Abstract

PURPOSE:

Diabetes mellitus (DM) is the most common cause of end-stage renal disease (ESRD) and an important risk factor for cardiovascular (CV) disease. We investigated the impact of DM on subclinical CV damage by comprehensive screening protocol in ESRD patients.

MATERIALS AND METHODS:

Echocardiography, coronary computed tomography angiogram, 24-h ambulatory blood pressure monitoring, and central blood pressure with pulse wave velocity (PWV) were performed in 91 ESRD patients from the Cardiovascular and Metabolic disease Etiology Research Center-HIgh risk cohort.

RESULTS:

The DM group (n=38) had higher systolic blood pressure than the non-DM group (n=53), however, other clinical CV risk factors were not different between two groups. Central aortic systolic pressure (148.7±29.8 mm Hg vs. 133.7±27.0 mm Hg, p= 0.014), PWV (12.1±2.7 m/s vs. 9.4±2.1 m/s, p<0.001), and early mitral inflow to early mitral annulus velocity (16.7±6.4 vs. 13.7±5.9, p=0.026) were higher in the DM group. Although the prevalence of coronary artery disease (CAD) was not different between the DM and the non-DM group (95% vs. 84.4%, p=0.471), the severity of CAD was higher in the DM group (p=0.01). In multivariate regression analysis, DM was an independent determinant for central systolic pressure (p=0.011), PWV (p<0.001) and the prevalence of CAD (p=0.046).

CONCLUSION:

Diabetic ESRD patients have higher central systolic pressure and more advanced arteriosclerosis than the non-DM control group. These findings suggest that screening for subclinical CV damage may be helpful for diabetic ESRD patients.

KEYWORDS:

End-stage renal disease; coronary artery disease; diabetes mellitus; hypertension; target organ damage

PMID:
27873498
PMCID:
PMC5122655
DOI:
10.3349/ymj.2017.58.1.75
[Indexed for MEDLINE]
Free PMC Article

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