Clinical Significance of Cardio-Ankle Vascular Index as a Cardiovascular Risk Factor in Elderly Patients With Type 2 Diabetes Mellitus

BACKGROUND: The cardio-ankle vascular index (CAVI) is a novel physiological marker of atherosclerosis that reflects systemic arterial stiffness. The aim of this study was to clarify the clinical significance of CAVI as a risk factor for cardiovascular diseases (CVDs) in elderly patients with type 2 diabetes mellitus. METHODS: This cross-sectional study enrolled 216 elderly (≥ 65 years) outpatients with type 2 diabetes mellitus who were undergoing antidiabetic treatment (96 males and 120 females; mean age, 75 ± 7 years (mean ± standard deviation)). Associations between CAVI and various clinical parameters were examined. RESULTS: CAVI was significantly higher in patients with a history of CVD than in those without a history of CVD (10.4 ± 1.4 vs. 9.5 ± 1.0, respectively, P < 0.001). There were significantly positive correlations between CAVI and various clinical parameters, such as skin autofluorescence (r = 0.47, P < 0.001), high-sensitivity cardiac troponin T levels (r = 0.39, P < 0.001), and reactive oxygen metabolite levels (r = 0.28, P < 0.001). Furthermore, multiple regression analyses revealed that these clinical parameters ((skin autofluorescence (β = 0.30, P < 0.001), high-sensitivity cardiac troponin T levels (β = 0.18, P < 0.001), reactive oxygen metabolite levels (β = 0.15, P < 0.01), and a history of CVD (β = 0.19, P < 0.001)) were independent variables when CAVI was used as a subordinate factor. CONCLUSION: Findings of this study indicate that CAVI may be an important CVD risk factor in elderly patients with type 2 diabetes mellitus. Further investigations in a large number of prospective studies, including intervention therapies, are required to validate our results.