Associations between macrovascular and renal microvascular dysfunction in type 2 diabetes and non-diabetes: the HELIUS study

• Published in: Microvascular research 2021-07, Vol.136, p.104162-104162, Article 104162
• Main Authors: Hayfron-Benjamin, Charles F., Amoah, Albert G.B., Maitland - van der Zee, Anke H., Moll van Charante, Eric Peter, Galenkamp, Henrike, van den Born, Bert-Jan, Agyemang, Charles
• Format: Article
• Language: English
• Subjects: Adult; Albuminuria; Albuminuria - diagnosis; Albuminuria - ethnology; Albuminuria - physiopathology; Aortic stiffness; Cardiovascular disease; Coronary artery disease; Coronary Artery Disease - diagnosis; Coronary Artery Disease - ethnology; Coronary Artery Disease - physiopathology; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Nephropathies - diagnosis; Diabetic Nephropathies - ethnology; Diabetic Nephropathies - physiopathology; Female; Humans; Macrovascular dysfunction; Male; Microvascular dysfunction; Middle Aged; Netherlands - epidemiology; Peripheral Arterial Disease - diagnosis; Peripheral Arterial Disease - ethnology; Peripheral Arterial Disease - physiopathology; Peripheral artery disease; Risk Assessment; Risk Factors; Stroke; Stroke - diagnosis; Stroke - ethnology; Stroke - physiopathology; The HELIUS study; Type 2 diabetes; Vascular Stiffness
• ISSN: 0026-2862; 1095-9319
• DOI: 10.1016/j.mvr.2021.104162

Although the associations between measures of macrovascular and microvascular dysfunctions are well characterized in diabetes, there is limited data on these associations in individuals without diabetes. We compared the associations between macrovascular dysfunction and renal microvascular dysfunction in individuals with type 2 diabetes (T2D) and without diabetes. Cross-sectional analyses of baseline data from the multiethnic Healthy Life in an Urban Setting (HELIUS) study (Amsterdam, the Netherlands), including 986 participants with T2D and 7680 participants without diabetes were done. Logistic regression analyses were used to examine the associations between macrovascular dysfunction [aortic stiffness, coronary artery disease (CAD), peripheral artery disease (PAD), and stroke] and renal microvascular dysfunction [albuminuria] with adjustments for age, sex, ethnicity, waist-to-hip ratio, systolic blood pressure, LDL-cholesterol, and smoking (and HbA1c and diabetes duration for the T2D group). In the fully adjusted models, aortic stiffness was associated with albuminuria in individuals with T2D [OR 2.55; 95% CI,1.30–4.98], but not without diabetes [0.96; 0.63–1.45]; stroke was associated with albuminuria in T2D [2.40;1.10–5.25], but not in non-diabetes [1.39;0.83–2.33]. In age-sex adjusted models, CAD was associated with albuminuria in T2D [1.65;1.09–2.50] and in non-diabetes [1.56;1.13–2.15]; the associations were no longer significant in the fully adjusted model. There were no associations between PAD and albuminuria in T2D and non-diabetes. Our study shows important differences in the associations between measures of macrovascular and renal microvascular dysfunction in T2D and non-diabetes. These findings provide opportunities for future research aimed at prevention and treatment strategies for individuals with vascular dysfunction. •Macrovascular dysfunction (MvD) rates were higher in T2D than in non-diabetes.•MvD was more frequently associated with albuminuria in T2D than in non-diabetes.•In a fully adjusted model, stroke was associated with albuminuria in T2D only.•After full adjustment, aortic stiffness was associated with albuminuria in T2D only.•Peripheral artery disease wasn't associated with albuminuria in T2D or non-diabetes.