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Diabetes and menopause aggravate age-dependent deterioration in arterial stiffness

Shapiro, Yula MD1; Mashavi, Margarita MD1,2; Luckish, Ela MD1; Shargorodsky, Marina MD2,3

doi: 10.1097/GME.0000000000000231
Original Articles

Objective: The present study was designed to evaluate the effects of menopause status and diabetes on arterial stiffness, metabolic parameters, and inflammatory parameters in premenopausal and postmenopausal women with and without type 2 diabetes mellitus.

Methods: In the present study, 186 women were divided into three groups: group 1 includes 42 premenopausal women without type 2 diabetes mellitus, group 2 includes 85 postmenopausal women without diabetes, and group 3 includes 59 postmenopausal women with diabetes. Blood glucose, hemoglobin A1c, insulin, lipids, C-reactive protein, homeostasis model assessment–insulin resistance, aldosterone, and renin were measured. Pulse wave velocity (PWV) and augmentation index (AI) were determined using SphygmoCor (version 7.1; AtCor Medical, Sydney, Australia).

Results: PWV and AI values increased from group 1 to group 3 in a continuous fashion. Postmenopausal women with and without diabetes exhibited significantly increased AI compared with premenopausal women without diabetes (P < 0.0001 and P < 0.0001, respectively). PWV was significantly higher in postmenopausal women with diabetes mellitus than in premenopausal and postmenopausal women without diabetes mellitus (P = 0.007 and P = 0.002, respectively).

Conclusions: Postmenopausal women without diabetes have significantly higher AI compared with premenopausal women without type 2 diabetes mellitus. The combination of diabetes and postmenopause status is associated with further deterioration of AI and PWV independently of age, body mass index, and other cardiovascular risk factors.

From the 1Department of Internal Medicine, Wolfson Medical Center, Holon, Israel; 2Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and 3Department of Endocrinology, Wolfson Medical Center, Holon, Israel.

Received December 31, 2013; revised and accepted February 12, 2014.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Marina Shargorodsky, MD, Wolfson Medical Center, PO Box 5, Holon 58100, Israel. E-mail:

© 2014 by The North American Menopause Society.