Donate Help Contact The AHA Sign In Home
American Heart Association
Stroke
Search: search_blue_button Advanced Search
« Previous Article | Table of Contents | Next Article »
Stroke. 2004;35:671-676
Published online before print February 12, 2004, doi: 10.1161/01.STR.0000115752.58601.0B
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
35/3/671    most recent
01.STR.0000115752.58601.0Bv1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Henry, R. M.A.
Right arrow Articles by Stehouwer, C. D.A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Henry, R. M.A.
Right arrow Articles by Stehouwer, C. D.A.
Related Collections
Right arrow Remodeling
Right arrow Pathophysiology
Right arrow Type 2 diabetes
Right arrow Glucose intolerance
Right arrow Other Vascular biology

(Stroke. 2004;35:671.)
© 2004 American Heart Association, Inc.

Original Contributions

Carotid Arterial Remodeling

A Maladaptive Phenomenon in Type 2 Diabetes but Not in Impaired Glucose Metabolism: The Hoorn Study

Ronald M.A. Henry, MD; Piet J. Kostense, PhD; Jacqueline M. Dekker, PhD; Giel Nijpels, MD, PhD; Robert J. Heine, MD, PhD; Otto Kamp, MD, PhD; Lex M. Bouter, PhD Coen D.A. Stehouwer, MD, PhD

From the Institute for Research in Extramural Medicine (R.M.A.H., P.J.K., J.M.D., G.N., R.J.H., L.M.B., C.D.A.S.), Institute for Cardiovascular Research (R.M.A.H.), and Departments of Clinical Epidemiology and Biostatistics (P.J.K.), Cardiology (O.K.), Endocrinology (R.J.H.), and Internal Medicine (C.D.A.S.), VU Medical Center, Amsterdam, the Netherlands.

Correspondence to Professor C.D.A. Stehouwer, MD PhD, Department of Internal Medicine, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands. E-mail cda.stehouwer{at}vumc.nl

Background and Purpose— Deteriorating glucose tolerance is associated with an increased cardiovascular disease (CVD) risk. The underlying mechanisms remain unclear. Arterial remodeling is the change in structural properties through time in response to atherogenic and/or hemodynamic alterations and aims to maintain circumferential wall stress constant ({sigma}C). Arterial remodeling has not been studied in relation to glucose tolerance.

Methods— The study population consisted of 278 people with normal glucose metabolism, 168 with impaired glucose metabolism, and 301 with type 2 diabetes (DM-2); their mean age was 67.8 years. We assessed carotid intima-media thickness (IMT), interadventitial diameter (IAD), lumen diameter (LD), and {sigma}C.

Results— After adjustment for age, sex, height, body mass index, and prior CVD, DM-2 was associated with increased IAD, IMT, and {sigma}C but not LD (regression coefficients: 0.24 mm; 95% confidence interval [CI], 0.07 to 0.41; 0.050 mm; 95% CI, 0.024 to 0.077; 5.00 kPa; 95% CI, 0.92 to 9.08; and 0.13 mm; 95% CI, -0.03 to 0.29, respectively). After additional adjustment for pulse pressure, the association between DM-2 and IAD disappeared, whereas the association with IMT remained. After adjustment, impaired glucose metabolism was not significantly associated with LD (0.12 mm; 95% CI, -0.06 to 0.33), {sigma}C (0.25 kPa; 95% CI, -4.49 to 4.98), IAD (0.08 mm; 95% CI, -0.11 to 0.27), or IMT (0.029 mm; 95% CI, -0.002 to 0.060). However, the IMT regression coefficient was half that of DM-2.

Conclusions— DM-2 is associated with preserved LD at increased IMT, which, however, does not normalize the increased {sigma}C. In contrast, impaired glucose metabolism is not associated with changes in LD or IAD, whereas IMT is moderately increased but {sigma}C remains constant. Carotid remodeling in DM-2 thus appears maladaptive, which may explain the increased CVD risk, especially stroke, in DM-2.


Key Words: arterial remodeling • carotid arteries • diabetes mellitus • epidemiology




This article has been cited by other articles:


Home page
 British Journal of Diabetes & Vascular DiseaseHome page
D. Sander, K. Sander, and H. Poppert
Review: Stroke in type 2 diabetes
The British Journal of Diabetes & Vascular Disease, September 1, 2008; 8(5): 222 - 229.
[Abstract] [PDF]

Home page
 Cardiovasc ResHome page
G. Spinetti, N. Kraenkel, C. Emanueli, and P. Madeddu
Diabetes and vessel wall remodelling: from mechanistic insights to regenerative therapies
Cardiovasc Res, May 1, 2008; 78(2): 265 - 273.
[Abstract] [Full Text] [PDF]

Home page
 HypertensionHome page
C. Giannattasio, M. Failla, A. Capra, E. Scanziani, M. Amigoni, L. Boffi, C. Whistock, P. Gamba, F. Paleari, and G. Mancia
Increased Arterial Stiffness in Normoglycemic Normotensive Offspring of Type 2 Diabetic Parents
Hypertension, February 1, 2008; 51(2): 182 - 187.
[Abstract] [Full Text] [PDF]

Home page
 DiabetesHome page
E. Ruiz, A. Gordillo-Moscoso, E. Padilla, S. Redondo, E. Rodriguez, F. Reguillo, A. M. Briones, C. van Breemen, E. Okon, and T. Tejerina
Human vascular smooth muscle cells from diabetic patients are resistant to induced apoptosis due to high bcl-2 expression.
Diabetes, May 1, 2006; 55(5): 1243 - 1251.
[Abstract] [Full Text] [PDF]

Home page
 StrokeHome page
M. L. Bots, D. E. Grobbee, A. Hofman, and J. C.M. Witteman
Common Carotid Intima-Media Thickness and Risk of Acute Myocardial Infarction: The Role of Lumen Diameter
Stroke, April 1, 2005; 36(4): 762 - 767.
[Abstract] [Full Text] [PDF]


Stroke Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search
Copyright © 2004 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited.