Journal
DIABETES CARE
Volume 34, Issue 4, Pages 886-891Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc10-2013
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Funding
- Folkhalsan Research Foundation
- Helsinki University Central Hospital
- Wilhelm and Else Stockmann Foundation
- Waldemar von Frenckell Foundation
- Liv och Halsa Foundation
- Finnish Medical Society (Finska Lakaresallskapet)
- Diabetes Research Foundation
- Paavo Nurmi Foundation
- Biomedicum Helsinki Foundation
- Nylands Nation Foundation
- Paulo Foundation
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OBJECTIVE-Pulse pressure (PP), an estimate of arterial stiffness, has been shown to be associated with incident cardiovascular disease (CVD) in patients with type 1 diabetes (T1D). However, diabetic kidney disease, a strong predictor of CVD, was not previously taken into account. Furthermore, the role of PP as a predictor of diabetic nephropathy is not known. Therefore, we prospectively investigated the associations between PP and these diabetes complications in patients with T1D. RESEARCH DESIGN AND METHODS-A total of 4,509 patients from the Finn Diane Study participated. Follow-up data on incident CVD events and renal status (median 5.3 years) were available in 69 and 76% of the patients, respectively. Altogether, 269 patients (8.6%) had an incident CVD event and 370 patients (10.8%) progressed to a higher level of albuminuria or to end-stage renal disease. RESULTS-PP was higher at baseline in patients who experienced a CVD event (66 18 vs. 52 +/- 14 mmHg; P < 0.001) or progressed in their renal status (58 +/- 18 vs. 54 +/- 15 mmHg; P < 0.01) during follow-up. In a Cox regression model, PP was independently associated with a first ever CVD event (hazard ratio per 10 mmHg 1.22 [95% CI 1.10-1.34]) but not progression of renal disease (1.00 [0.89-1.12]) after adjustments for traditional risk factors. CONCLUSIONS-PP, a marker of arterial stiffness, is a risk factor for cardiovascular complications but not for diabetic nephropathy in patients with T1D. Diabetes Care 34:886-891, 2011
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