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The Impact of Diabetes Mellitus on Vascular Biomarkers in Patients with End-Stage Renal Disease.

 Jeonggeun Moon  ;  Chan Joo Lee  ;  Sang-Hak Lee  ;  Seok-Min Kang  ;  Donghoon Choi  ;  Tae-Hyun Yoo  ;  Sungha Park 
 YONSEI MEDICAL JOURNAL, Vol.58(1) : 75-81, 2017 
Journal Title
Issue Date
Aged ; Aorta ; Biomarkers ; Blood Pressure/physiology ; Blood Pressure Monitoring, Ambulatory ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/physiopathology* ; Diabetes Mellitus/physiopathology* ; Diabetic Nephropathies/physiopathology ; Echocardiography ; Female ; Humans ; Kidney Failure, Chronic/physiopathology* ; Male ; Middle Aged ; Pulse Wave Analysis ; Regression Analysis ; Risk Factors ; Systole/physiology
End-stage renal disease ; coronary artery disease ; diabetes mellitus ; hypertension ; target organ damage
PURPOSE: Diabetes mellitus (DM) is the most common cause of end-stage renal disease (ESRD) and an important risk factor for cardiovascular (CV) disease. We investigated the impact of DM on subclinical CV damage by comprehensive screening protocol in ESRD patients. MATERIALS AND METHODS: Echocardiography, coronary computed tomography angiogram, 24-h ambulatory blood pressure monitoring, and central blood pressure with pulse wave velocity (PWV) were performed in 91 ESRD patients from the Cardiovascular and Metabolic disease Etiology Research Center-HIgh risk cohort. RESULTS: The DM group (n=38) had higher systolic blood pressure than the non-DM group (n=53), however, other clinical CV risk factors were not different between two groups. Central aortic systolic pressure (148.7±29.8 mm Hg vs. 133.7±27.0 mm Hg, p= 0.014), PWV (12.1±2.7 m/s vs. 9.4±2.1 m/s, p<0.001), and early mitral inflow to early mitral annulus velocity (16.7±6.4 vs. 13.7±5.9, p=0.026) were higher in the DM group. Although the prevalence of coronary artery disease (CAD) was not different between the DM and the non-DM group (95% vs. 84.4%, p=0.471), the severity of CAD was higher in the DM group (p=0.01). In multivariate regression analysis, DM was an independent determinant for central systolic pressure (p=0.011), PWV (p<0.001) and the prevalence of CAD (p=0.046). CONCLUSION: Diabetic ESRD patients have higher central systolic pressure and more advanced arteriosclerosis than the non-DM control group. These findings suggest that screening for subclinical CV damage may be helpful for diabetic ESRD patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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