Factors Affecting Pulse Wave Velocity in Type 2 Diabetic Patients

【Background/Purpose】The purpose of this study was to define the progression of atherosclerosis in patients with type 2 diabetes mellitus (T2DM) using brachial-ankle pulse wave velocity (ba-PWV) and to clarify the relationship between ba-PWV and body composition factors, muscle strength, and patient characteristics. 【Methods】Atherosclerosis indices such as ba-PWV (cm/s) and systolic blood pressure (SBP; mmHg), body composition such as weight (kg) and muscle mass (kg), anthropometric parameters such as body mass index (BMI; kg/m2) and leg circumference (cm), hematological data such as HbA1c (%), and background factors such as medical history and age (years) were evaluated. Statistical analysis was performed using Pearson’s product rate correlation coefficient, Spearman’s rank correlation coefficient, multiple regression analysis, logistic regression analysis, and ANCOVA (p < 0.05). 【Results】The mean age was 63.12 ± 11.96 years; BMI, 25.58 ± 4.35 kg/m2; ba-PWV, 1666.03 ± 368.19 cm/s; SBP, 139.36 ± 16.52 mmHg; disease duration, 11.25 ± 9.45 years; and HbA1c, 6.9 ± 0.72%. BMI, HbA1c (%), abnormal achilles reflex, leg circumference (%), sex, knee extensor strength (kgf-m/kg), and years of illness (years) were dependent variables, and age (years) and SBP were adjusted variables. BMI (odds ratio 0.84, 95% confidence interval [CI] 0.726 – 0.965, p < 0.001) was included in a binomial logistic regression analysis with other variables. The cut-off BMI value was 26.28 kg/m2 (area under the curve 0.71, 95% CI 0.60 – 0.82). In ANCOVA, when BMI was the group variable, ba-PWV was the dependent variable and age was the independent variable; there was no interaction between the group and independent variables (p = 0.246), and BMI and age were significant explanatory factors for ba-PWV (p < 0.05). 【Discussion】This study showed that BMI was related to the frequency of arterial stiffness in T2DM patients and proposed a cutoff BMI value. These results provide a starting point for the evaluation of arterial stiffness in home health care settings for T2DM patients.