Key result
Hypertensive patients with type 2 diabetes had significantly higher ET-1 levels than controls, while MMP-2 and MMP-9 were significantly elevated in both pre-hypertensive and hypertensive groups.
Why the study?
Do pre-hypertensive and hypertensive patients with type 2 diabetes have different serum concentrations of ET-1, MMP-2, and MMP-9 compared to healthy normotensive controls?
Cross-Sectional
Do pre-hypertensive and hypertensive patients with type 2 diabetes have different serum concentrations of ET-1, MMP-2, and MMP-9 compared to healthy normotensive controls?
Increased levels of MMP-2 and MMP-9 reflect early vascular changes in pre-hypertensive patients with type 2 diabetes, while elevated ET-1 is associated with established hypertension.
May signal staged vascular remodeling in T2D hypertension; hypothesis-generating and leaves clinical utility open pending prospective data.
Endothelin-1 (ET-1) is one of the most potent vasoconstrictors known to date. While its plasma or serum concentrations are elevated in some forms of experimental and human hypertension, this is not a consistent finding in all forms of hypertension. Matrix metalloproteinases -2 and -9 (MMP-2 and MMP-9), which degrade collagen type IV of the vascular basement membrane, are responsible for vascular remodeling, inflammation, and atherosclerotic complications, including in type 2 diabetes (T2D). In our study, we compared concentrations of ET-1, MMP-2, and MMP-9 in pre-hypertensive (PHTN) and hypertensive (HTN) T2D patients with those of healthy normotensive controls (N). ET-1, MMP-2, and MMP-9 were measured by ELISA. Concentrations of ET-1 in PHTN and N were very similar, while those in HTN were significantly higher. Concentrations of MMP-2 and MMP-9 in PHTN and HTN were also significantly higher compared to N. An interesting result in our study is that concentrations of MMP-2 and MMP-9 in HTN were lower compared to PHTN. In conclusion, we showed that increased production of ET-1 in patients with T2D can lead to long-lasting increases in blood pressure (BP) and clinical manifestation of hypertension. We also demonstrated that increased levels of MMP-2 and MMP-9 in pre-hypertensive and hypertensive patients with T2D mainly reflect the early vascular changes in extracellular matrix (ECM) turnover.
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Kostov et al. (2016) conducted a cross-sectional in Type 2 diabetes with pre-hypertension or hypertension. Hypertensive patients with type 2 diabetes had significantly higher ET-1 levels than controls, while MMP-2 and MMP-9 were significantly elevated in both pre-hypertensive and hypertensive groups.
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