Study Finds BMI and Type 2 Diabetes Independently Increase Arterial Stiffness

A new study published in Diabetes, Metabolic Syndrome and Obesity reports that type 2 diabetes (T2DM) and body mass index (BMI) both independently contribute to increased arterial stiffness, with BMI accounting for the majority of vascular impairment. The cross-sectional analysis of 255 Chinese adults found no synergistic interaction between the two conditions, suggesting their effects on the arteries are additive rather than multiplicative.

The retrospective, matched cross-sectional study enrolled 255 participants: 129 with T2DM and 126 matched controls without diabetes. Controls were matched based on age (±5 years), sex, and BMI category. T2DM was diagnosed according to World Health Organization criteria, and participants with T2DM were classified into three BMI-based categories: lean (BMI <25 kg/m², n=48), overweight (BMI 25–29.9 kg/m², n=44), and obese (BMI ≥30 kg/m², n=37). Carotid intima-media thickness (IMT) and pulse wave velocity (PWV) were measured using ultrasound imaging.

Compared to the diabetes-free group, those with T2DM had significantly greater IMT and PWV (P<0.001). Among people with T2DM, an increasing BMI category was associated with progressive increases in IMT and PWV (P<0.001). Multivariable analysis revealed that BMI category was strongly associated with carotid IMT (standardized β 0.715, 95% CI: 113.4–174.7) and PWV (standardized β 0.544, 95% CI: 0.81–1.73), indicating a progressive impact of BMI on arterial stiffness. No interaction was observed between T2DM and BMI (IMT: P-interaction=0.95; PWV: P-interaction=0.56), supporting independent effects.

The study concludes that T2DM and BMI have additive but non-synergistic effects on arterial stiffness, with BMI driving most of the vascular impairment. The cross-sectional design, however, precludes causal inferences. The findings underscore the clinical relevance of weight management in people with T2DM.