Uncorrected flow-mediated dilation was lower in IDDM patients (12.0% vs 15.7%, P=0.046), but endothelium-dependent and -independent vasodilation were normal after correcting for baseline diameter.
Case-Control (n=104)
Is endothelium-dependent and -independent vasodilation impaired in normoalbuminuric patients with insulin-dependent diabetes mellitus compared to healthy controls?
Endothelial function, as measured by flow-mediated dilation, appears preserved in normoalbuminuric patients with insulin-dependent diabetes mellitus when accounting for baseline vessel diameter.
Absolute Event Rate: 12% vs 15.7%
p-value: p=.046
Vascular complications in diabetes mellitus are associated with endothelial dysfunction. Whether endothelium-dependent vasodilation is impaired in normoalbuminuric patients with insulin-dependent diabetes mellitus (IDDM) is controversial. Using a noninvasive echo-Doppler method, we investigated endothelium-dependent and endothelium-independent vasodilation in the brachial artery of IDDM patients. There were 52 normoalbuminuric and normotensive patients with IDDM (aged 31.9 +/- 9.8 years; diabetes duration, 14.9 +/- 7.9 years; glycated hemoglobin, 7.9 +/- 1.2%) and 52 healthy control group (C) subjects comparable for age and sex studied. Brachial artery diameter was measured at baseline, during postocclusion reactive hyperemia (flow-mediated, endothelium-dependent dilation FMD), and after 400 micrograms glyceryl trinitrate (GTN) sublingually (endothelium-independent vasodilation). Vasodilation was expressed as the percentage change relative to the baseline diameter. Baseline flow and blood pressure were similar for IDDM patients and C. Baseline vessel diameter was slightly larger in IDDM patients (3.10 +/- 0.52 mm) compared with C (2.89 +/- 0.55 mm, P = 5.0). FMD in IDDM patients was decreased (12.0 +/- 9.1% versus 15.7 +/- 9.5% in C, P = .046), as was GTN-induced vasodilation (14.9 +/- 8.2% versus 18.3 +/- 8.5% in C, P = .045). After correction for the difference in baseline diameter, FMD and GTN-induced dilation were not different between the groups. GTN-induced vasodilation decreased slightly with increasing diabetes duration. There was no relation between the vasodilatory responses and HbA1c. In normoalbuminuric IDDM patients, endothelium-dependent as well as endothelium-independent vasodilation are normal when the difference in baseline diameter is taken into account.
Lambert et al. (Wed,) conducted a case-control in Insulin-dependent diabetes mellitus (n=104). Insulin-dependent diabetes mellitus vs. Healthy controls was evaluated on Flow-mediated, endothelium-dependent dilation (FMD) (p=.046). Uncorrected flow-mediated dilation was lower in IDDM patients (12.0% vs 15.7%, P=0.046), but endothelium-dependent and -independent vasodilation were normal after correcting for baseline diameter.