Type 2 diabetes mellitus is associated with increased arterial stiffness measured by the echo-tracking method

INTRODUCTION: Data for arterial stiffness (АS) in type 2 diabetes mellitus (Т2DM) patients is important for better management of cardiovascular complications and early therapeutic approach.AIM: The aim of this article is to obtain data for pulse wave velocity (PWVβ) and other AS parameters in patients with T2DM without cardiovascular atherosclerotic disease and compare them with controls.MATERIALS AND METHODS: This cross-sectional clinical investigation involves a sample of 100 patients with T2DM without cardiovascular complications and a control group of 30 healthy subjects.  In all patients one-point echo-tracking measurement of carotid artery (CA) stiffness with Aloka Prosound α7 machine were conducted and pulse wave velocity (PWVβ), β-stiffness index, arterial compliance (АС), augmentation index (AI), Peterson’s modulus (Ep) were measured.  RESULTS AND CONCLUSION: Our results showed the mean value of PWVβ on the left CA (L) in the group of patients with T2DM is 7.37 ± 1.32 m/sec and on the right CA (R) is 7.42 ± 1.33 m/sec. The performed t-test showed statistical significance of the differences of PWVβ (L) and PWVβ (R) in the studied group, compared to the control group (t = 3.764; p = 0.001 and t = 3.561; p = 0.001). The data showed significantly higher values of β-stiffness index (p = 0.001) and Ep (p = 0.001) in patients with T2DM compared to controls. AC was significantly lower in T2DM, when it is measured on the left CA (p = 0.001). AI was significantly higher in T2DM when it is measured on the right CA (p = 0.009).Patients with T2DM are associated with significantly increased AS parameters compared to controls

Functional, Structural and Molecular Investigations into Experimental Type-1 and Type-2 Diabetes-induced Cardiomyopathy

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Developing technologies to assess vascular ageing: a roadmap from VascAgeNet

Vascular ageing is the deterioration of arterial structure and function which occurs naturally with age, and which can be accelerated with disease. Measurements of vascular ageing are emerging as markers of cardiovascular risk, with potential applications in disease diagnosis and prognosis, and for guiding treatments. However, vascular ageing is not yet routinely assessed in clinical practice. A key step towards this is the development of technologies to assess vascular ageing. In this Roadmap, experts discuss several aspects of this process, including: measurement technologies; the development pipeline; clinical applications; and future research directions. The Roadmap summarises the state of the art, outlines the major challenges to overcome, and identifies potential future research directions to address these challenges

A longitudinal evaluation of novel outcome measures in chronic obstructive pulmonary disease

Background Chronic obstructive pulmonary disease (COPD) is a multimorbidity disease associated with increased risk of cardiovascular events, arterial stiffness and changes in body composition, potentially features of premature ageing and frailty. The aim of this thesis was to assess the change in aortic pulse wave velocity (PWV) over two years and its contributing factors in COPD. In addition, this thesis also aimed to examine the concept of frailty in patients with COPD and its change over a two-year follow-up. Methods Aortic stiffness and frailty were assessed cross-sectionally in 500 patients with COPD and 150 comparators using aortic PWV and frailty index (FI). Other assessments included spirometry, body composition, handgrip strength, Timed Up and Go test (TUG) and systemic inflammatory biomarkers. After two years, 143 consecutive patients were reassessed to examine the changes in aortic PWV and FI. Results In the cross-sectional data, patients with COPD had greater aortic PWV than comparators similar in age, gender and BMI, independent of traditional risk factors. After two years, the patients demonstrated a significant increase in aortic stiffness, independent of age, lung function, blood pressure and inflammation. In addition, a subset of patients was identified to have an accelerated aortic stiffness by 1.6 m/s. At the initial visit, the patients were more frail than comparators similar in age and gender. After two years, the patients had an increase in the FI, independent of lung function and inflammation. The progression of frailty was related to loss of muscle mass and strength, and prolonged TUG time. Conclusion The longitudinal findings of this thesis suggest that COPD is associated with a rapid increase in aortic stiffness, independent of conventional risk factors. Frailty is a clinical feature of COPD and its progression is dependent on loss of musculoskeletal mass and strength and prolonged TUG time

Serum proteomics to detect early changes in type 1 diabetes and carotid atherosclerosis

The detection of early markers is the key issue in predicting the outcome of inflammatory diseases such as type 1 diabetes and atherosclerosis. Whilst biochemical testing approaches have improved prediction of inflammatory diseases, validated biomarkers with better diagnostic specificities are still needed. Currently, majority of the disease-related proteomics studies have focused on their endpoints. The work presented in this thesis includes the first comprehensive proteomics analyses on serum samples collected from two unique Finnish longitudinal cohorts, namely The Diabetes Prediction and Prevention Project (DIPP) and The Cardiovascular Risk in Young Finns Study (YFS), to identify early markers associated with type 1 diabetes and carotid atherosclerosis. Using mass spectrometry (MS)-based quantitative serum proteomics, profiling was carried out to the study temporal variation in pre-diabetic samples and early markers of plaque formation with the T1D and YFS cohorts, respectively. The analyses revealed consistent differences in the abundance of a number of proteins in subjects having an ongoing asymptomatic changes, several of which are functionally relevant to the disease process. Taken together, the discovered markers are candidates for further validation studies in an independent cohorts and may be used to characterize an increased risk, progression and early onset of these diseases.Tyypin 1 diabeteksen ja ateroskleroosin kehittymiseen liittyvät varhaiset muutokset seerumiproteomissa Yksi keskeinen haaste tulehduksellisten sairauksien, kuten tyypin 1 diabeteksen ja ateroskleroosin, ennustamisessa on varhaisten tautimarkkerien löytäminen. Vaikka erilaiset biokemialliset testit ovat jo parantaneet tulehdusperäisten sairauksien ennustamista, uusia tarkempia biomarkkereita tarvitaan edelleen. Tästä huolimatta monissa näiden alojen proteomiikkatöissä on nykyisin keskitytty sairastumishetken tutkimiseen. Tämän väitöskirjatyön aikana olemme tehneet laajamittaiset proteomiikka-analyysit seeruminäytteille, jotka on kerätty osana kahta ainutlaatuista suomalaista seurantatutkimusta: DIPP-tutkimusta (tyypin 1 diabeteksen ennustaminen ja ennaltaehkäisy) ja YFS-tutkimusta (sydän- ja verisuonitautien riski nuorilla suomalaisilla). Näissä tutkimuksissa seerumiproteomiikkaa hyödynnettiin ensimmistä kertaa varhaisten tyypin 1 diabetes- ja ateroskleroosimarkkerien etsimiseen. Tutkimme tyypin 1 diabeteksen kehittymiseen ja ateroskleroottisten plakkien muodostumiseen liittyviä muutoksia seerumin proteomiprofiileissa massaspektrometriaan perustuvan kvantitatiivisen proteomiikan avulla. Nämä analyysit paljastivat johdonmukaisia eroja lukuisissa proteiineissa myöhemmin sairastuneiden oireettomien henkilöiden ja terveinä pysyneiden kontrollien välillä. Monet näistä proteiineista saattavat myös liittyä olennaisesti tautien kehittymiseen. Tutkimuksissamme löydetyt markkerit tarjoavat lähtökohdan tuleville validointitutkimuksille, ja niitä voitaisiin tulevaisuudessa käyttää yksilön kohonneen sairastumisriskin, taudin etenemisen sekä taudin varhaisen puhkeamisen kartoittamiseen