Impact of Cardiometabolic Risk Markers on the Incidence and Progression Arterial Stiffness in Patients With Prediabetes

BACKGROUND: Previous studies have reported that insulin resistance (IR), blood pressure, body mass index (BMI), and dyslipidemia are associated with arterial stiffness. However, limited evidence exists regarding these relationships in prediabetes patients. The purpose of this study was to investigate the longitudinal associations between cardiometabolic risk markers and progression of arterial stiffness. METHODS: This study included 5771 adults with prediabetes at baseline from the Shougang cohort study. Cardiometabolic risk markers included the triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, mean arterial pressure (MAP), BMI, and dyslipidemia. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV), and its progression was defined as the annual change in baPWV between baseline and the last visit. Multivariate linear and logistic regression models were used to investigate the associations. RESULTS: Multivariate linear regression analyses showed TyG index, TG/HDL-C ratio, MAP, and dyslipidemia were significantly associated with baseline baPWV. Over a mean follow-up of 3.24 years, each one-unit increase in the MAP was significantly associated with a faster progression of baPWV (difference, 0.72 cm/s per year; 95% CI, 0.40 to 1.04 cm/s per year). After adjusting for all covariates, the risk for arterial stiffness increased 3% with each one-unit increase of MAP. CONCLUSION: Among individuals with prediabetes, MAP showed consistent longitudinal associations with arterial stiffness, highlighting the importance of early blood pressure management for vascular protection prior to the onset of diabetes.