ADA 2021 | Worsening arterial stiffness, HRV over time in younger individuals with kind 2 diabetes


medwireNews: Research from the TODAY2 study, reported at the ADA’s 81st virtual scientific sessions, suggests that young people with type 2 diabetes, especially those with poor glycemic control and high blood pressure, develop over time experience deterioration in arterial stiffness and heart rate variability (HRV).

Amy Shah (Cincinnati Children’s Hospital, Ohio, USA) and colleagues evaluated data from 304 people (34% men) who participated in the TODAY study and who performed arterial stiffness and HRV measurements in the subsequent TODAY2 longitudinal observational study. At the beginning of TODAY2 the participants were on average 20.8 years old, with a mean duration of diabetes of 7.7 years and a mean glycated hemoglobin (HbA1c) value of 8.8% (73 mmol / mol).

Shah reported that two measurements of arterial stiffness increased significantly from baseline TODAY 2 by 5 years of follow-up. The mean carotid-femoral pulse wave velocity (cf-PWV) increased from 6.3 to 7.1 m / s, while the mean augmentation index increased from 9.4% to 14.9%. Overall, 68.7% and 73.6% of the people experienced a deterioration in these measures.

The mean HRV also worsened significantly over the study period, from 50.8 ms at baseline to 40.1 ms after 5 years, with 66.8% of participants experiencing a decrease in HRV.

“The observed annual change in cf-PWV in the TODAY2 cohort is comparable to [that seen in] Adults around the age of 50 who have had diabetes for around 15 to 20 years, ”said Shah.

She added, “The low HRV seen at both initial and follow-up visits suggests that adolescents with recent type 2 diabetes may be at high risk for future cardiovascular complications.”

Using a multivariable model fitted for factors such as age, BMI, smoking, and low-density lipoprotein cholesterol, the researchers found that higher cumulative glycemic exposure, as measured by time-weighted HbA1c levels, was significantly associated with deterioration in cf PWV and HRV was connected. while females and a higher mean arterial blood pressure were significantly associated with a deterioration in the augmentation index.

Conversely, there were no associations between race / ethnicity and worsening arterial stiffness, or HRV, Shah said.

“Lowering HbA1c and blood pressure may be important in improving long-term cardiovascular outcomes in this cohort,” she concluded.

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Scientific meetings of the ADA; 25-29 June 2021