Chen, D., Jenkins, A. J., Greenlaw, N. , Dudman, K. , Fernandes, T., Carty, D. M., Hughes, A. D., Januszewski, A. S., Stehouwer, C. D. A. and Petrie, J. R. (2023) Cardiometabolic risk factors, peripheral arterial tonometry and metformin in adults with type 1 diabetes participating in the REducing with MetfOrmin Vascular Adverse Lesions trial. Diabetes and Vascular Disease Research, 20(3), p. 14791641231183634. (doi: 10.1177/14791641231183634) (PMID:37387358) (PMCID:PMC10328035)
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Abstract
Background: Peripheral arterial tonometry (PAT) provides non-invasive measures of vascular health. Beneficial effects of metformin on vascular function have been reported in youth with type 1 diabetes (T1D). In the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial in adults with T1D and high cardiovascular risk, we examined: (i) the extent to which routinely-measured cardiometabolic risk factors explain variance in baseline PAT; and (ii) the effects of metformin on PAT measures. Methods: Cross-sectional univariable and multivariable analyses of baseline reactive hyperaemia index (RHI) and augmentation index (AI) (EndoPAT® (Itamar, Israel); and analysis of 36-months metformin versus placebo on vascular tonometry. Results: In 364 adults ((mean ± SD) age 55.2 ± 8.5 years, T1D 34.0 ± 10.6 years, HbA1c 64.5 ± 9.0 mmol/mol (8.1 ± 0.8%)), RHI was 2.26 ± 0.74 and AI was 15.9 ± 19.2%. In an exhaustive search, independent associates of (i) RHI were smoking, waist circumference, systolic blood pressure and vitamin B12 (adjusted R2 = 0.11) and (ii) AI were male sex, pulse pressure, heart rate and waist circumference (adjusted R2 = 0.31). Metformin did not significantly affect RHI or AI. Conclusion: Cardiometabolic risk factors explained only a modest proportion of variance in PAT measures of vascular health in adults with T1D and high cardiovascular risk. PAT measures were not affected by metformin.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Dudman, Ms Katie and Greenlaw, Miss Nicola and Carty, Dr David and Petrie, Professor John |
| Authors: | Chen, D., Jenkins, A. J., Greenlaw, N., Dudman, K., Fernandes, T., Carty, D. M., Hughes, A. D., Januszewski, A. S., Stehouwer, C. D. A., and Petrie, J. R. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
| Journal Name: | Diabetes and Vascular Disease Research |
| Publisher: | SAGE Publications |
| ISSN: | 1479-1641 |
| ISSN (Online): | 1752-8984 |
| Published Online: | 30 June 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in Diabetes and Vascular Disease Research 20(3): 14791641231183634 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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