Diabetes & Metabolism Journal

Original Article

Relationships between Brachial-Ankle Pulse Wave Velocity and Peripheral Neuropathy in Type 2 Diabetes: Byung Kil Ha, Bong Gun Kim, Dong Hyun Kim, Soon Il Lee, Soon Myung Jung, Ja Young Park, Chang Won Lee, Sang Soo Kim, Bo Hyun Kim, In Ju Kim; Diabetes Metab J. 2012;36(6):443-451. Published online December 12, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.6.443

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Background

Brachial-ankle pulse wave velocity (baPWV) is known to be a good surrogate marker of clinical atherosclerosis. Atherosclerosis is a major predictor for developing neuropathy. The goal of this study was to determine the relationship between baPWV and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes.

Methods

A retrospective cross-sectional study was conducted involving 692 patients with type 2 diabetes. The correlation between increased baPWV and DPN, neurological symptoms, and neurological assessment was analyzed. DPN was examined using the total symptom score (TSS), ankle reflexes, the vibration test, and the 10-g monofilament test. DPN was defined as TSS ≥2 and an abnormal neurological assessment. Data were expressed as means±standard deviation for normally distributed data and as median (interquartile range) for non-normally distributed data. Independent t-tests or chi-square tests were used to make comparisons between groups, and a multiple logistic regression test was used to evaluate independent predictors of DPN. The Mantel-Haenszel chi-square test was used to adjust for age.

Results

Patients with DPN had higher baPWV and systolic blood pressure, and were more likely to be older and female, when compared to the control group. According to univariate analysis of risk factors for DPN, the odds ratio of the baPWV ≥1,600 cm/sec was 1.611 (95% confidence interval [CI], 1.072 to 2.422; P=0.021) and the odds ratio in female was 1.816 (95% CI, 1.195 to 2.760; P=0.005).

Conclusion

Increased baPWV was significantly correlated with peripheral neuropathy in patients with type 2 diabetes.

Citations

Citations to this article as recorded by

Factors Affecting Arterial Stiffness and Brachial-Ankle Pulse Wave Velocity in Patients With Type 2 Diabetes
Tomoki Furuya, Shinji Kitahama, Yuma Tamura, Susumu Ogawa, Yuki Nakatani, Takanori Yasu
Cureus.2024;[Epub] CrossRef
Efficient Mapping of Tissue Oxygen Saturation Using Hyperspectral Imaging and GAN
Minhye Chang, Wonju Lee, Kye Young Jeong, Jun Wan Kim, Chang Hee Jung
IEEE Access.2024; 12: 153822. CrossRef
Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis
Angela Beros, John Sluyter, Robert Keith Rhodes Scragg
BMJ Open Diabetes Research & Care.2023; 11(1): e003140. CrossRef
A Noninvasive Blood Glucose Estimation System Using Dual-Channel PPGs and Pulse-Arrival Velocity
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IEEE Sensors Journal.2023; 23(19): 23570. CrossRef
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Journal of Diabetes Investigation.2021; 12(11): 2028. CrossRef
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Bingwei Ma, Yao Chen, Chunjun Sheng, Peng Yang, Xingchun Wang, Shen Qu
European Journal of Clinical Nutrition.2021; 75(11): 1645. CrossRef
Electrical impedance plethysmography versus tonometry to measure the pulse wave velocity in peripheral arteries in young healthy volunteers: a pilot study
A. I. P. Wiegerinck, A. Thomsen, J. Hisdal, H. Kalvøy, C. Tronstad
Journal of Electrical Bioimpedance.2021; 12(1): 169. CrossRef
Peripheral Arterial Stiffness Increases the Risk of Progression of Renal Disease in Type 2 Diabetic Patients
Tae Hoon Lim, Seung Min Chung, Dong Sung Lee, Se Ra Choi, Jun Sung Moon, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee
Frontiers in Medicine.2020;[Epub] CrossRef
High Brachial Ankle Pulse Wave Velocity as a Marker for Predicting Coronary Artery Stenosis in Patients with Type 2 Diabetes
Bo Hyun Kim, Jae Sik Jang, Yong Seop Kwon, June Hyung Kim, In Joo Kim, Chang Won Lee
Endocrinology and Metabolism.2018; 33(1): 88. CrossRef
Nerve conduction velocity is negatively associated with intima-media thickness and brachial-ankle pulse wave velocity in men with type 2 diabetes mellitus
Sayuri Tanaka, Ippei Kanazawa, Toshitsugu Sugimoto, Rayaz A. Malik
PLOS ONE.2018; 13(12): e0209503. CrossRef
The association between pulse wave velocity and peripheral neuropathy in patients with type 2 diabetes mellitus
Anastasios Tentolouris, Ioanna Eleftheriadou, Pinelopi Grigoropoulou, Alexander Kokkinos, Gerasimos Siasos, Ioannis Ntanasis-Stathopoulos, Nikolaos Tentolouris
Journal of Diabetes and its Complications.2017; 31(11): 1624. CrossRef
Neurogenic Pain Disorder in the Foot and Ankle: Peripheral Neuropathy
Hak Jun Kim, Young Hwan Park, Soo Hyun Kim
Journal of the Korean Orthopaedic Association.2017; 52(4): 305. CrossRef
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Jun Ouk Ha, Tae Hee Lee, Chang Won Lee, Ja Young Park, Seong Ho Choi, Hee Seung Park, Jae Seung Lee, Seung Heon Lee, Eun Hee Seo, Young Hwan Kim, Young Woo Kang
Diabetes & Metabolism Journal.2016; 40(4): 297. CrossRef
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Po-Chi Hsu, Yu-Chuen Huang, John Y. Chiang, Hen-Hong Chang, Pei-Yung Liao, Lun-Chien Lo
BMC Complementary and Alternative Medicine.2016;[Epub] CrossRef
Aortic Stiffness as a Surrogate Endpoint to Micro- and Macrovascular Complications in Patients with Type 2 Diabetes
Claudia Cardoso, Gil Salles
International Journal of Molecular Sciences.2016; 17(12): 2044. CrossRef
Brachial-Ankle Pulse Wave Velocity is Associated with Composite Carotid and Coronary Atherosclerosis in a Middle-Aged Asymptomatic Population
Hyung Joon Joo, Sang-A Cho, Jae-Young Cho, Seunghun Lee, Jae Hyoung Park, Sung Ho Hwang, Soon Jun Hong, Cheol Woong Yu, Do-Sun Lim
Journal of Atherosclerosis and Thrombosis.2016; 23(9): 1033. CrossRef
Arterial stiffness in diabetes mellitus
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Atherosclerosis.2015; 238(2): 370. CrossRef
Association between Brachial-Ankle pulse wave velocity and cardiac autonomic neuropathy in type 2 diabetes
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Randomized Controlled Trial

Effects of Telmisartan Compared with Valsartan on Plasma Adiponectin Levels and Arterial Stiffness in Patients with Type 2 Diabetes: A Pilot Study.: Soo Yeon Park, Sin Gon Kim, Juri Park, Yun Jeong Lee, Hee Young Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2008;32(3):236-242. Published online June 1, 2008; DOI: https://doi.org/10.4093/kdj.2006.32.3.236

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Abstract PDF: BACKGROUND
Telmisartan, used for the treatment of hypertension, has been shown to function as a partial agonist of peroxime proliferative activated receptor-nu (PPAR-nu). Theoretically, telmisartan which simultaneously blocks the angiotensin II receptor and activates PPAR-nu should be more effective in improving atherosclerotic surrogate markers than angiotensin II receptor blockers alone. Therefore, this pilot study was designed to evaluate and compare the efficacy of telmisartan and valsartan on plasma adiponectin levels and pulse wave velocity as a marker of arterial stiffness in patients with type 2 diabetes. METHODS: Thirty two patients with type 2 diabetes (mean duration 7.6 +/- 5.1 years) taking oral hypoglycemic agents were randomly assigned to receive telmisartan or valsartan for 12 weeks. RESULTS: Telmisartan and valsartan treatment significantly increased circulating adiponectin levels (P = 0.013 and P = 0.013, respectively) and reduced systolic (P = 0.001 and P = 0.002, respectively) and diastolic blood pressure (P = 0.001 and P < 0.001, respectively), and brachial-ankle PWV (P = 0.019 and P = 0.002, respectively), without significant differences between the two treatments. Before and after treatment, the fasting plasma glucose, interleukin-6, homeostasis model of assessment insulin resistance (HOMAIR) levels and lipid profile were unchanged in both treatment groups. CONCLUSION: Contrary to our expectation, telmisartan, even with its partial PPAR-nu activity, is not superior to valsartan in improving plasma adipocytokine levels and arterial stiffness in patients with type 2 diabetes. These data suggest that the partial PPAR-nu activity of telmisartan beyond valsartan may have less significant therapeutic implications than expected in treating patients with type 2 diabetes.

Original Article

Brachial-ankle Pulse Wave Velocity in Koreans with the Metabolic Syndrome.: Kyung Mook Choi, Kye Won Lee, Sul Hye Ryoung, Ji A Seo, Jeong Heon Oh, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2004;28(1):36-44. Published online February 1, 2004

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Abstract PDF: BACKGROUND
The clustering of cardiovascular risk factors is known as metabolic syndrome. In this study, the association between the brachial-ankle pulse wave velocity(baPWV), a novel non-invasive means of measuring atherosclerosis, and the cardiovascular risk factors of the metabolic syndrome were investigated. METHODS: The study group comprised 460 non-diabetic Koreans, male:female ratio 158:302, with a mean age of 52.4+/-11.3 years. The anthropometric parameters, blood pressure, fasting blood glucose(FBG), lipid profiles, ankle-brachial pressure index(ABI) and baPWV were measured in each subject. RESULTS: The ABI and baPWV levels were significantly higher in the men than the women. In both the men and women, the baPWV was closely associated with the cardiovascular risk factors of the metabolic syndrome. Those who had more metabolic syndrome components showed higher baPWV levels. Women with metabolic syndrome showed higher baPWV levels compared to those without (1517+/-281 vs. 1336+/-250, P<0.001). A multiple regression analysis showed the baPWV to be significantly associated with systolic blood pressure, age, gender, body mass index (BMI) and FBG (adjusted R-square 0.554). CONCLUSIONS: The present study shows that the baPWV was significantly associated with the features of metabolic syndrome, including the FBG, in non-diabetic Koreans.

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