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Research Article
Volume 6 Issue 6 - 2021
Pulse Wave Analysis of HbA1c Categorized Prediabetes, Type 2 Diabetes and Normo-Glycemic Populations: A Pilot Study
Jennifer J Brown1,2* and Sheri R Colberg1
1Old Dominion University, Norfolk, Virginia, United States
2Elizabeth City State University, Elizabeth City, North Carolina, United States
*Corresponding Author: Jennifer J Brown, Elizabeth City State University, Elizabeth City, North Carolina, United States.
Received: May 14, 2021; Published: June 02, 2021




Abstract

Introduction: Arterial stiffness is a significant risk factor for cardiovascular events and early detection is key for intervention and monitoring. This pathophysiological process is accelerated in type 2 diabetes (T2D), yet the onset of this condition has a limited body of research.

Purpose: To evaluate (1) arterial stiffness properties via pulse wave analysis (PWA) across a 4-group spectrum, and (2) determine whether waist-to-height-ratio (WHtR), waist circumference (WC) or body mass index (BMI) serves as the best predictor of early changes in PWA pathophysiology.

Methods: PWA was measured in 52 participants across four groups separated by HbA1c values: 14 normo-glycemic (N, 4.0 % -5.1 %), 15 high normal (HN, 5.2%-5.6 %), 10 prediabetes (PD, 5.7% -6.4 %) and 13 with T2D (T2D, ≥ 6.5%). Brachial, central and peripheral pressures, central and peripheral augmentation index (AIx) data were collected via Sphygmocor using validated methods after overnight caffeine abstinence and a minimum 4-hr fast. Group differences were evaluated via MANCOVAs. HbA1c, WHtR, WC and BMI data were assessed through regression to determine the best predictor.

Results: Significant differences were found between N to T2D and HN to T2D for brachial systolic blood pressure (SBP) [F(3,46) = 2.743, p < .05], brachial diastolic blood pressure (DBP) [F(3,46) = 3.329, p < .028] and brachial mean pressures (MP) [F(3,46) = 4.321, p < .009]. Central DBP and MP differed between N to T2D, and HN to PD and T2D groups [DBP:F(3,44) = 3.874, p < .015; MP:F(3,44) = 3.303, p < .029]. Central pulse pressure (PP) and CAIx showed no differences between groups. Peripheral pressures significantly differed between N and both PD and T2D; HN and both PD and T2D groups for peripheral SBP [F(3,44) = 3.007, p < .040], peripheral DBP [F(3,44) = 4.316, p < .009] and peripheral MP [F(3,44) = 3.487, p < .023], but not PP or PAIx. WHtR and WC were identified as the best predictors of CAIx after adjusting for age and height [R2 = .800, F(5,45) = 16.023, p < .0005; adj. R2 = .640], while PAIx had no significant predictor.

Conclusion: PWA may be effective for identifying differences in multiple brachial, central and peripheral pressure measures across a novel, pre-defined HbA1c spectrum; however, more research needs to be executed to validate these findings. WHtR and WC, but not BMI, effectively predicts CAIx

Keywords: Pulse Wave; Early Detection; Arterial Stiffness; Cardiovascular; Prediabetes

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Citation: Jennifer J Brown and Sheri R Colberg. “Pulse Wave Analysis of HbA1c Categorized Prediabetes, Type 2 Diabetes and Normo-Glycemic Populations: A Pilot Study”. EC Endocrinology and Metabolic Research 6.6 (2021): 01-12.

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