Higher brachial-ankle pulse wave velocity linked to development of diabetes and insulin resistance: Study

A new study published in the Journal of American Heart Association found that even within the "normal" range, elevated brachial-ankle pulse wave velocity (baPWV) is a major predictor of the development of diabetes and insulin resistance.

Adult diabetes prevalence is predicted to increase from 10.5% in 2021 to 12.2% by 2045 by impacting 783.2 million individuals worldwide. New studies have discovered that elevated vascular stiffness is a risk factor for diabetes as well as a consequence of it. Regardless of the precise metrics employed, a number of population studies have discovered that elevated arterial stiffness raises the chance of acquiring diabetes.

A greater carotid-femoral pulse wave velocity (cfPWV) was linked to a number of health outcomes, including the development of diabetes, according to the Framingham Heart Study. Yet, it is still unclear what processes underlay the link between arterial stiffness and diabetes risk. Using a large cohort of young and middle-aged Korean individuals, the study's objective was to evaluate the risk of diabetes in accordance with baPWV, stratified by age and sex, and linked with IR.

None of the 119,170 Korean people in this cohort research, who had an average age of 39.8 years, developed diabetes at baseline. Measurements of baPWV were obtained as part of a health check. Insulin levels, glycated hemoglobin, fasting blood glucose, and questionnaire responses were gathered over a median follow-up period of 5.6 years. A flexible parametric proportional hazards model was used to assess the risk of diabetes, stratifying the data by age group (≥40 years versus ≥40 years) and sex.

A total of 5966 individuals (5.0%) were diagnosed with diabetes throughout the follow-up period. The hazard ratios for diabetes onset linked to baPWV quartiles Q2 (1171.0–1270.5 cm/s), Q3 (1271.0–1376.0 cm/s), and Q4 (≥1376.5 cm/s) were 1.06 (95% CI, 0.96–1.17), 1.25 (1.14–1.38), and 1.48 (1.34–1.62), respectively, according to a fully adjusted model (P for trend <0.001).

This connection was found to have a substantial sex-based interaction, with women having a greater chance of developing diabetes. Also, according to the homeostatic model evaluation of insulin resistance, greater baPWV quartiles were linked to a higher chance of developing insulin resistance. Overall, with a focus on baPWV as a marker, the results of this study emphasized the significance of arterial stiffness monitoring as an early indication of possible diabetes development.

Source:

Kang, J., Jeon, K., Choi, K., Choi, H., & Sung, K. (2024). Brachial‐Ankle Pulse Wave Velocity as a Predictor of Diabetes Development: Elevated Risk Within Normal Range Values in a Low‐Risk Population. In Journal of the American Heart Association (Vol. 13, Issue 24). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1161/jaha.124.037705