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Singapore Med J2014; 55(4): 202-208; http://dx.doi.org/10.11622/smedj.2014053
Association between urinary 8-OHdG and pulse wave velocity in hypertensive patients with type 2 diabetes mellitus
Kotani K, Yamada T
Correspondence: Dr Kazuhiko Kotani, kazukotani@jichi.ac.jp
ABSTRACT
INTRODUCTION Oxidative stress, assessed using 8-hydroxy-2’-deoxyguanosine (8-OHdG), can be associated with arterial stiffness in patients with type 2 diabetes mellitus (T2DM) and/or hypertension (HT). We investigated the correlation between urinary 8-OHdG and pulse wave velocity (PWV) in hypertensive and non-hypertensive T2DM patients with fair glycaemic control to determine the clinical significance of HT as a comorbidity in the diabetic state.
METHODS Clinical data, including traditional cardiovascular risk factors, diabetic complications, prescribed agents, urinary 8-OHdG level and brachial-ankle PWV, was collected from T2DM patients with and without HT.
RESULTS There were 76 patients (45 men, 31 women; mean age 61 years; mean haemoglobin A1c level 6.5%) in the study cohort. T2DM patients with HT had significantly higher mean PWV than patients without HT (1,597 cm/s vs 1,442 cm/s; p < 0.05). Patients with HT showed no significant difference in 8-OHdG levels relative to those without HT (median 7.9 ng/mg creatinine vs 8.8 ng/mg creatinine; p > 0.05). Simple linear correlation and stepwise multiple linear regression analyses revealed that 8-OHdG levels correlated independently, significantly and positively with PWV among T2DM patients with HT (r = 0.33, p < 0.05; β= 0.23, p < 0.05). No significant correlation was observed between 8-OHdG levels and PWV among T2DM patients without HT.
CONCLUSION In the hypertensive state, oxidative stress can be responsible for the development of arterial stiffness, even in patients with fairly well controlled T2DM. Oxidative stress management may be necessary for the prevention of cardiovascular disease in this population.
Keywords: arterial stiffness, atherosclerosis, DNA damage, oxidative stress, pulse wave velocity
Singapore Med J2014; 55(4): 202-208; http://dx.doi.org/10.11622/smedj.2014053
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