5 :: KDA, Korean Diabetes Association ::
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Subject    :    [2018 Aug;42(4)] Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus
Writer KDA
Date 2019-03-06 09:53:17 Hit 333
Diabetes Metab J. 2018 Aug;42(4):285-295. English.
Published online Jul 27, 2018.  https://doi.org/10.4093/dmj.2017.0080 
Copyright © 2018 Korean Diabetes Association
   
Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus
So Young Park,1 Sang Ook Chin,2 Sang Youl Rhee,2 Seungjoon Oh,2 Jeong-Taek Woo,2 Sung Woon Kim,2 and Suk Chon2
1Department of Medicine, Graduate School of Medicine, Kyung Hee University, Seoul, Korea.
2Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.

Corresponding author: Suk Chon. Department of Endocrinology and Metabolism, Kyung Hee University Hospital, Kyung Hee University School of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea. Email: imdrjs@khu.ac.kr 
 
Received November 21, 2017; Accepted April 07, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



Abstract

Background

Carotid artery intima medial thickness (IMT), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) are commonly used surrogate markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The cardio-ankle vascular index (CAVI) is a complement to the baPWV, which is affected by blood pressure. However, it is unclear which marker is the most sensitive predictor of atherosclerotic cardiovascular disease (ASCVD).

Methods

This was a retrospective non-interventional study that enrolled 219 patients with T2DM. The correlations among IMT, ABI, and CAVI as well as the relationship of these tests to the 10-year ASCVD risk were also analyzed.

Results

Among the 219 patients, 39 (17.8%) had ASCVD. In the non-ASCVD group, CAVI correlated significantly with IMT after adjusting for confounding variables, but ABI was not associated with CAVI or IMT. The analyses after dividing the non-ASCVD group into three subgroups according to the CAVI score (<8, ≥8 and <9, and ≥9) demonstrated the significant increase in the mean IMT, 10-year ASCVD risk and number of metabolic syndrome risk factors, and decrease in the mean ABI in the high-CAVI group. A high CAVI was an independent risk factor in the non-ASCVD group for both a high 10-year ASCVD risk (≥7.5%; odds ratio [OR], 2.42; P<0.001) and atherosclerosis (mean IMT ≥1 mm; OR, 1.53; P=0.007).

Conclusion

In Korean patients with T2DM without ASCVD, CAVI was the most sensitive of several surrogate markers for the detection of subclinical atherosclerosis.

   
Keywords:
AtherosclerosisCardiovascular diseasesDiabetes mellitus, type 2Korea

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