Stiffness parameter β (stiffness β), a clinical estimate of arterial stiffness, increases with the progression of systemic atherosclerosis. Atherosclerosis is frequently and severely observed in patients with diabetic kidney disease (DKD) which is defined by decreased estimated glomerular filtration rate (eGFR) and/or elevated urinary albumin creatinine ratio (UACR). Both decreased eGFR and elevated UACR are known as risk factors of atherosclerosis. However, the contribution of each factor, eGFR or UACR, to arterial stiffness remains unclear. The present study aimed to investigate the association of eGFR or UACR with stiffness β in type 2 diabetes. Stiffness β was measured using ultrasonography at common carotid artery (CCA). The total 1,924 participants with type 2 diabetes including 58.8% of male were enrolled in this cross-sectional study. The mean age and HbA1c of all participants were 61.1 years and 8.6 %, respectively. The proportion of each CKD stage of eGFR (mL/min/1.73m2) and UACR (mg/g creatinine) were as follows: eGFR, 70.5% in G1/2 (≥ 60), 14.1% in G3a (45 - 60), 6.3% in G3b (30 - 45), and 9.0% in G4/5 (< 30); UACR, 61.5% in A1 (< 30), 20.3% in A2 (30 - 299), and 18.1% in A3 (≥ 300). Stiffness β (unitless) in G1/2, G3a, G3b, and G4/5 were 13.4 ± 5.8(SD), 15.0 ± 6.5, 16.1 ± 7.3, and 16.5 ± 7.4, respectively; and those in A1, A2, and A3 were 13.4 ± 5.9, 14.9 ± 6.1, and 15.8 ± 7.1, respectively. In univariate analysis, stiffness β was significantly correlated with both eGFR (r = −0.237, p < 0.001) or UACR (r = 0.161, p < 0.001). In multiple regression analyses, stiffness β was independently associated with UACR (β = 0.047, p = 0.043), but not with eGFR (β = −0.019, p = 0.439) after adjustment for classical risk factors.
In conclusion, stiffness β of CCA is associated with UACR, but not with eGFR, in patients with type 2 diabetes. Our findings suggest that stiffness β is more closely associated with UACR than eGFR in type 2 diabetes.
S. Nakatani: None. Y. Kakutani: None. T. Morioka: Research Support; Boehringer-Ingelheim, Eli Lilly and Company. Y. Yamazaki: None. A. Ochi: None. K. Mori: Speaker's Bureau; Mitsubishi Tanabe Pharma Corporation, Novo Nordisk, AstraZeneca, Lilly Diabetes, Kyowa Kirin Co., Ltd. T. Shoji: Speaker's Bureau; Kowa Company, Ltd., Bayer Inc., Ono Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd. M. Emoto: Research Support; Boehringer-Ingelheim, Sumitomo Dainippon Pharma Co., Ltd., Mitsubishi Tanabe Pharma Corporation. Speaker's Bureau; Sumitomo Dainippon Pharma Co., Ltd., Kyowa Kirin Co., Ltd. Research Support; Chugai Pharmaceutical.
