Endocrinology and Metabolism

The Korean Endocrine Society (대한내분비학회)
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Determinants of the Brachial-Ankle Pulse Wave Velocity (baPWV) in Patients with Type 2 Diabetes Mellitus

제2형 당뇨병 환자의 상완-발목 맥파 속도(Brachial-Ankle Pulse Wave Velocity)에 영향을 미치는 인자

Lee, Seong-Woo;Yun, Kyung-Won;Yu, Yun-Sik;Lim, Hong-Kyu;Bae, Yung-Pil;Lee, Byung-Do;Kim, Bo-Hyun;Lee, Chang-Won
이성우;윤경원;유연식;임홍규;배영필;이병도;김보현;이창원

  • Published : 20080800
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Abstract

Background: Pulse wave velocity (PWV) correlates with arterial distensibility and stiffness and is a useful method for evaluating the severity of systemic atherosclerosis in adults. Brachial-ankle PWV (baPWV) is affected by many different factors such as age, systolic blood pressure (SBP), sex, body mass index, waist to hip ratio, and HbA1c. We evaluated the determinants of baPWV in patients with type 2 diabetes mellitus. Methods: The study included 803 type 2 diabetic patients over age 30 who had their ankle brachial pressure index (ABI) and baPWV measured at Busan St. Mary`s Medical Center, Busan, Korea. Anthropometric parameters, blood pressure, pulse pressure, fasting plasma glucose, fasting insulin, HbA1c, lipid profile, high sensitivity C-reactive protein (hs-CRP), and microalbuminuria were checked concurrently. We also investigated tobacco and alcohol use by means of questionnaire. We then retrospectively analyzed the relationships between baPWV and various risk factors. Results: Differences between men and women were measured using the independence sample probate. Pearson correlation analysis confirmed the factors affecting the baPWV as follows: SBP, diastolic blood pressure, pulse pressure, age, waist circumference, gender, and duration of diabetes mellitus were positively correlated, and height and weight were negatively correlated. On aged-adjusted partial correlation, HbA1c, SBP, diastolic blood pressure, and pulse pressure were correlated. By multiple linear regression analysis, SBP, age, HbA1c, and weight were independent predictors of baPWV. Conclusion: The baPWV is principally affected by SBP and age in patients with type 2 diabetes mellitus.

연구배경: 동맥파 속도(pulse wave velocity, PWV)는 동맥의 팽창성, 경직도와 연관이 있으며, 성인에서 전신적인 죽상경화증의 중증도를 평가하는데 유용하게 사용할 수 있다. 나이 수축기 혈압 등이 맥파속도에 영향을 주는 인자로 알려져 있으나, 제2형 당뇨병 환자만을 대상으로 상완-발목 맥파속도에 영향을 미치는 인자에 대하여 알아보고자 하였다. 방법: 제2형 당뇨병으로 부산성모병원에서 치료 중인 30세 이상의 801명의 환자를 대상으로 ABI (ankle brachial pressure index), 상완-발목 맥파속도를 측정하였다. 대상자들은 성별, 나이, 흡연력, 음주력을 조사하였고, 혈압, 맥압, 지질농도, 공복혈당 및 공복인슐린, 당화혈색소, 고민감도 C-반응성 단백 등을 측정하였다. 상완-발목 맥파속도와 여러 위험인자들 간의 상관관계를 후향적으로 분석하였다. 결과: 남녀간의 차이는 독립표본 검증을 이용하였다. 상완-발목 맥파속도에 영향을 미치는 인자를 확인하기 위해Pearson 및 Spearman 방법으로 조사한 결과, 수축기 혈압, 이완기 혈압, 맥압, 나이, 허리둘레, 성별, 당뇨병 유병기간 등이 의미 있는 양의 상관관계를 보였고 키, 몸무게는 음의 상관관계를 보였다. 나이를 보정한 경우에는 당화혈색소, 수축기 혈압, 이완기 혈압, 맥압이 유의한 상관관계를 보였다. 상완-발목 맥파속도를 종속변수로 선형다중회귀분석을 한 결과 수축기 혈압, 나이, 당화혈색소, 몸무게와 유의한 상관관계를 보였다. 결론: 상완-발목 맥파속도는 여러 변수에 의해 영향을 받으며 수축기 혈압과 나이에 가장 영향을 받는다는 것을 알 수 있었다.

Keywords

References

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