Diabetes mellitus exacerbates cardiovascular remodeling in elderly Chinese by affecting aortic diameter and pulsatile load.

Yuqi Jiang, Ziwei Zhao, JunFeng Jiang, Yanxia Lin, Pengcheng Jiang, Yimeng Niu, Huanrui Zhang, Wen Tian

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Observational study in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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8 authors.

Yuqi JiangDepartment of Geriatrics, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, China.

Ziwei ZhaoDepartment of Geriatrics, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, China.

JunFeng JiangDepartment of Geriatrics, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, China.

Yanxia LinDepartment of Geriatrics, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, China.

Pengcheng JiangDepartment of Geriatrics, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, China.

Yimeng NiuDepartment of Geriatrics, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, China.

Huanrui ZhangDepartment of Geriatrics, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, China.

Wen TianDepartment of Geriatrics, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, China. wtian56@cmu.edu.cn.

Funding

Liaoning Provincial Applied Basic Research Program 2022JH2/101300061Shenyang Science and Technology Project (2024) - Special Project for Public Health Research and Development 24-214-3-10

6 · The paper itself

Abstract

Cardiovascular health is negatively impacted by arterial stiffening, which increases pulsatile load and elevates left ventricular workload. Aortic dilatation may compensate for the pulsatile overload resulting from arterial stiffening. Previous studies have shown a negative correlation between diabetes and aortic diameter, suggesting that diabetes may impair aortic dilatation and thereby compromise compensatory buffering capacity. This study aims to explore the relationship between diabetes, aortic diameter, and left ventricular hypertrophy. This retrospective study included 271 elderly patients stratified by diabetes status. Aortic and cardiac geometry was measured via echocardiography, and arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV). Pulse pressure (PP) was used as an index of pulsatile load. Linear regression and mediation analyses were conducted to examine the associations among diabetes, aortic diameter, arterial stiffness, PP, and left ventricular mass index (LVMI). Diabetes, fasting blood glucose (FPG), and glycated hemoglobin (HbA1c) were independently associated with smaller aortic diameters (AoRi), with regression coefficients of - 0.984, - 0.275, and - 0.479, respectively. BaPWV was positively associated with AoRi (a = 0.942, P = 0.015), whereas AoRi was negatively correlated with PP (b =- 0.990, P < 0.001). BaPWV had a direct positive effect on PP (c' = 3.336, P = 0.024), which was counteracted by an indirect effect through AoRi (- 0.933, 95% CI - 2.133, - 0.028). Mediation analysis revealed that AoRi attenuated the effect of PP on LVMI (0.439, P < 0.001 vs. 0.308, P = 0.007) and amplified the effect of diabetes on PP (3.903, P = 0.031 vs. 4.732, P = 0.010). In the chain-mediated effect model, diabetes had a significant total effect on LVMI (β = 5.025, P = 0.043). The diabetes → AoRi → PP → LVMI pathway demonstrated a significant indirect effect (0.230, 95% CI 0.013-0.592). Diabetes is associated with impaired aortic dilatation and increased left ventricular hypertrophy, potentially serving as a pathological mechanism driving progression of myocardial hypertrophy.

Indexed as

AortaDiabetes MellitusHypertrophy, Left VentricularVascular RemodelingVentricular RemodelingAgedBlood PressureChinaEchocardiographyFemaleHumansMaleMiddle AgedPulse Wave AnalysisRetrospective StudiesVascular StiffnessAortic dilatationDiabetes mellitusLeft ventricular hypertrophyPulsatile load

Identifiers

PMID40890284

DOI10.1038/s41598-025-17924-z

PMCPMC12402055

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.