P4.08 INSULIN RESISTANCE IS THE MAIN TARGET IN PREVENTING ACCELERATING ARTERIAL AGING

Abstract

Objectives: Increased arterial stiffness (AS) is the most prominent feature of arterial aging. It has been shown an association of AS not only with age, but also with insulin resistance (IR). Leukocyte telomere length (TL) has been proposed as an independent predictor of CVD. The origin of the association between TL and CVD may be related to its effect on AS. TL attrition is accelerated by chronic inflammation and oxidative stress associated with IR. We assessed the hypothesis that TL attrition under the influence of IR leads to arterial stiffening. Methods: The study group included 99 subjects mean age 51.3 ±12.3 years, free of known CVD, 20 subjects had T2DM. Serum fasting glucose (FG), insulin, Hb1Ac were determined using routine laboratory methods. HOMA-IR was calculated as fasting insulin (mU/ml) × FG (mmol/l)/22,5. TL was determined by PCR. AS was evaluated by measuring aortic pulse wave velocity (PWV) with the help of SphygmoCor (AtCor Medical). Results: Through multiple linear regression analysis, PWV was found to be independently and positively associated with age, FG, Hb1Ac, independently and negatively associated with TL (see table 1). TL was found to be independently and negatively associated with age, HOMA-IR (see table 2). In all subjects age, TL, FG, Hb1Ac predicted 43% of the variance in PWV (p-0,0001). Age, HOMA-IR predicted 24% of the variance in TL (p-0,0001). Predictor β Standard Error p Age 0,099 0,028 0,001 Telomere length −0,658 0,309 0,037 Fasting glucose 0,388 0,160 0,017 Hb1Ac 0,801 0,362 0,031 Predictor β Standard Error p Age −0,026 0,010 0,015 HOMA-IR −0,176 0,056 0,027 Hb1Ac −0,213 0,148 0,155 In conclusion: TL along with indicators of glucose metabolism mainly determine arterial stiffness. There is a considerable impact of glucose regulation on telomere dynamics. IR may be the main target in preventing accelerating arterial aging.