Purpose: Arterial remodeling underlies the association between type 2 diabetes (T2D) and arterial stiffness. Remodeling may also affect the pressure-dependency of stiffness. Pressure-dependency can be quantified as the systolic-diastolic difference in pulse wave velocity (ΔPWV).

In the population-based Maastricht Study, we evaluated the associations between carotid stiffness (cPWV) and ΔPWV, and glucose metabolism status (GMS). Additionally, we investigated the interdependency of cPWV and ΔPWV in their association with GMS as to find out whether remodeling may act differentially upon cPWV and ΔPWV.

Methods: The study consisted of 594 individuals (312 normal glucose metabolism [NGM], 98 impaired glucose metabolism [IGM] and 184 T2D). cPWV and ΔPWV were determined by ultrasonography and tonometry. Regression analyses were used to investigate the associations of cPWV and ΔPWV with GMS (NGM as reference). Models were adjusted for age, sex, mean arterial pressure (MAP), and central pulse pressure, cPWV or ΔPWV as appropriate, and additionally for: anti-hypertensive medication, prior cardiovascular disease, estimated glomerular filtration rate, or body mass index.

Results: After adjustment for age, sex and MAP, T2D was associated with greater cPWV (β (95% CI; 0.284 (0.012–0.556)) and ΔPWV (0.299 (−0.005–0.603)). Further adjustments did not change these associations. After additional adjustment for cPWV or ΔPWV the associations with ΔPWV and cPWV attenuated (0.209 (−0.083–0.502) and 0.208 (−0.053–0.470), respectively). IGM was not associated with either cPWV or ΔPWV.

Conclusions: In T2D both cPWV and ΔPWV are increased. The associations were only partially interdependent, which suggests that remodeling impacts on both stiffness and its pressure-dependency.