A Comparative Study for an Assessment of Arterial Stiffness with Cardio-Ankle Vascular Index and Clinical Determinants between those Individuals with and without Diabetes

Vitoon Jularattanaporn MD¹, Thep Chalermchai MD¹

Affiliation : ¹ School of Antiaging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand

Background: Arterial stiffness and dysfunction are clinical determinants in predicting long-term cardiovascular risk in type 2 diabetes (T2DM). Cardio-ankle vascular index (CAVI) is a novel tool in detecting atherosclerosis by measuring arterial stiffness along the aorta to tibial arteries.
Objective: To compare clinical parameters between diabetes and non-diabetes groups. The present study explored clinical factors associated with CAVI of 8.0 or more in diabetes patients. Moreover, the study determined the correlation between CAVI and clinical predictors for long-term cardiovascular risk.
Materials and Methods: The present study was a retrospective, cross-sectional study. The controls or non-diabetes were matched with the cases or diabetes in ratio 2:1 and aged matched in two groups, 40 years and older and less than 40 years old.
Results: Two hundred fifty-two subjects were enrolled, 84 were diabetes and 168 were non-diabetes. The present study found those subjects with high body mass index (BMI) of 25.0 kg/m² or more and CAVI of 8.0 or more were the factors associated with greater risk of having diabetes than non-diabetes. Subjects with T2DM aged 40 years or older had 11.95 times greater risk of having CAVI of 8.0 or more than those younger than 40 years in T2DM (p=0.002). Known essential hypertension was another independent factor associated with 4.28 times greater risk of having CAVI of 8.0 or more than those without hypertension in T2DM (p=0.010). The present study found significant positive correlation between CAVI and the previously reported clinical markers, RAMA-EGAT score and the mean common carotid artery intima-media thickness, that predict long-term cardiovascular events in T2DM (Pearson’s correlation coefficient; r=0.6738 and 0.4207, respectively, p<0.05).
Conclusion: Those subjects with CAVI of 8.0 or more and BMI of 25 kg/m² or more had significantly greater association with diabetes than non- diabetes. Age of 40 years or older and history of hypertension were independent risk of high CAVI of 8.0 or more in T2DM. CAVI also correlated with the previously reported clinical marker to predict long-term cardiovascular risk such as RAMA-EGAT score, the mean common carotid artery intima-media thickness in T2DM.
Received 29 March 2021 | Revised 30 June 2021 | Accepted 5 July 2021

doi.org/10.35755/jmedassocthai.2021.08.12775

Keywords : Type 2 diabetes; Cardio-ankle vascular index (CAVI); Arterial stiffness

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