Dataset Information

Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study.

ABSTRACT: OBJECTIVE:Aortic stiffness is an important predictor of future morbidity and mortality. Diabetes is associated with increased aortic stiffness, but the importance of nondiabetic glucometabolic status for accelerated aortic stiffening is unclear. We tested the hypothesis that adverse glucometabolic status is associated with accelerated aortic stiffening in individuals without diabetes, independently of known risk factors for arterial stiffening. RESEARCH DESIGN AND METHODS:Glucometabolic status and other cardiovascular risk factors were assessed at baseline in 2008-09, and carotid femoral pulse wave velocity (cfPWV) at baseline and follow-up in 2012-13, in 4,386 participants without diabetes of the Whitehall II Study. RESULTS:The mean age of the cohort at cfPWV baseline was 60 years, and 74% were male. cfPWV increased from (mean ± SE) 8.30 ± 0.03 to 8.98 ± 0.04 m/s during 4 years of follow-up. At baseline, cfPWV was associated with fasting and 2-h postload glucose, HbA1c, and HOMA-insulin resistance (HOMA-IR). HbA1c and HOMA-IR were associated with progression of cfPWV after adjusting for physiological confounders and cardiovascular risk factors. A 1 SD higher HbA1c and HOMA-IR were associated with greater increases in cfPWV (0.11 m/s per 5 years [95% CI 0.04, 0.18], P = 0.003 and 0.09 m/s per 5 years [0.01, 0.17], P = 0.03, respectively). Additional adjustment for BMI weakened the association with HOMA-IR but not with HbA1c. CONCLUSIONS:HbA1c is independently associated with accelerated progression of aortic stiffness in individuals without diabetes. These findings suggest that long-term glucometabolic status, even in individuals without diabetes, could be an important target for preventative strategies against vascular aging.

SUBMITTER: McEniery CM

PROVIDER: S-EPMC5360278 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study.

McEniery Carmel M CM Wilkinson Ian B IB Johansen Nanna B NB Witte Daniel R DR Singh-Manoux Archana A Kivimaki Mika M Tabak Adam G AG Brunner Eric J EJ Shipley Martin J MJ

Diabetes care 20170125 4

<h4>Objective</h4>Aortic stiffness is an important predictor of future morbidity and mortality. Diabetes is associated with increased aortic stiffness, but the importance of nondiabetic glucometabolic status for accelerated aortic stiffening is unclear. We tested the hypothesis that adverse glucometabolic status is associated with accelerated aortic stiffening in individuals without diabetes, independently of known risk factors for arterial stiffening.<h4>Research design and methods</h4>Glucomet ...[more]

PMID: 28122839

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Project description:BACKGROUND:Arterial stiffness, and its progression with age, is an important indicator of cardiovascular aging. Greenspace exposure may protect against arterial stiffness by promoting physical activity, fostering social cohesion, and reducing stress and exposure to air pollution and noise. OBJECTIVES:The aim of this study was to investigate the association of long-term exposure to outdoor greenspace with arterial stiffness and its progression over time. METHODS:This prospective cohort study was based on 4,349 participants (55-83 years of age) of the Whitehall II Study, United Kingdom. Arterial stiffness was assessed in two medical examinations (2007-2009 and 2012-2013) by measuring the carotid-femoral pulse wave velocity (cf-PWV). Residential surrounding greenspace was characterized using satellite-based indices of greenspace including normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and vegetation continuous fields (VCF) across buffers of 500 and 1,000m surrounding the participants' residential locations at each follow-up. The association between the greenspace indicators and baseline cf-PWV and 4-year progression of cf-PWV was assessed using linear mixed-effects models with the participant as a random effect, controlling for demographic, lifestyle, and (individual and area) socioeconomic factors. RESULTS:No statistically significant associations were observed between residential surrounding greenspace and baseline or 4-y progression of cf-PWV; interquartile range (IQR) increases in NDVI, EVI, and VCF in the 500-m buffer were associated with -0.04m/s [95% confidence interval (CI): -0.12, 0.04], -0.03m/s (95% CI: -0.10, 0.05), and -0.02m/s (95% CI: -0.08, 0.04) in baseline cf-PWV and 0.06m/s (95% CI: -0.02, 0.14), 0.05m/s (95% CI: -0.03, 0.14), and 0.00m/s (95% CI: -0.09, 0.09) in 4-y progression in cf-PWV, respectively. The associations were similar when using 1,000-m buffers. CONCLUSIONS:We did not observe any consistent association between residential surrounding greenspace and arterial stiffness. https://doi.org/10.1289/EHP6159.

Dataset Information

Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study.

Publications

Nondiabetic Glucometabolic Status and Progression of Aortic Stiffness: The Whitehall II Study.

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