Association between Brachial-Ankle Pulse Wave Velocity and Large-Nerve Fiber Function in Chinese Adults Aged 18-65 Years with Type 2 Diabetes.

INTRODUCTION

Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV), has been linked to diabetic peripheral neuropathy (DPN). However, the evidence regarding its association with large-nerve fiber dysfunction, specifically assessed by vibration perception threshold (VPT), in Chinese patients aged 18-65 years with type 2 diabetes mellitus (T2DM) is scarce. This study aimed to investigate the relationship between baPWV and VPT in this specific population.

METHODS

This cross-sectional study enrolled 600 inpatients with T2DM aged 18-65 years. baPWV was measured using an automated waveform analyzer. DPN was defined as a VPT ≥15 volts in at least one foot. Multivariable logistic regression models were used to assess independent association, expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline and subgroup analyses were performed to evaluate the dose-response relationship and consistency of the association.

RESULTS

Among the participants, 165 (27.5%) were classified into the abnormal VPT group. After full adjustment for confounders including age, gender, diabetes duration, glycated hemoglobin, and lifestyle factors, each 100 cm/s increase in baPWV was significantly associated with increased odds of DPN (OR = 1.07, 95% CI: 1.01-1.14). When analyzed by quartiles, participants in the highest baPWV quartile (≥1,660 cm/s) had 1.29-fold higher odds of abnormal VPT (OR = 1.29, 95% CI: 1.03-3.01) compared to those in the lowest quartile (<1,380 cm/s), with a significant trend across quartiles (p for trend = 0.005). A linear dose-response relationship was confirmed without evidence of a threshold effect. Subgroup analyses showed the association was consistent across different patient characteristics.

CONCLUSION

Elevated baPWV is independently associated with higher odds of DPN measured by VPT in Chinese patients aged 18-65 years with type 2 diabetes. This linear relationship not only underscores the pivotal role of arterial stiffness in the pathogenesis of DPN but also positions baPWV as a valuable tool for early risk stratification in clinical practice.