Assessment of Circulatory Levels of Endothelin-1 in Diabetic Subjects Screened Through a Cross Sectional Study from Rural Women in Bangladesh

Aims: Endothelin-1 (ET-1), a potential marker of endothelial dysfunction, has been shown to be elevated in diabetic mellitus (DM) subjects. However, to date, the circulatory profile of ET-1 and its association with DM have not been investigated in any South Asian country, including Bangladesh. The present study assessed circulating levels of ET-1 in subjects with or without DM and further examined the association of ET-1 with clinical and metabolic parameters in Bangladeshi rural women. Main Methods: A total of 2022 rural Bangladeshi women were studied using a cross-sectional survey and then further analysis was performed based on a case control design between DM (n=195) and non-DM (204). Multiple regressions were used to examine the association between circulatory ET-1 level and DM. Key findings: A total of 2022 rural Bangladeshi women aged ≥15 years were studied using a population-based cross-sectional survey (DM prevalence is 9.1%). ET-1 levels were significantly increased in diabetes subjects [DM vs. non-DM: 3.11 ± 0.16 vs. 1.97 ± 0.03, p<0.001]. In multivariable analyses, after adjusting for age, ET-1was found to have significant positive association with waist circumference (p=0.029), fasting plasma glucose levels (p=0.001) and HDL-C (p=0.016). In multiple regression analysis considering ET-1 levels as a dependent variable, we found that plasma glucose levels and HDL-C are the independent determinants for plasma ET-1 levels in Bangladeshi rural women. Through tertile analysis, we found a significant increase in plasma levels of mean ET-1 as levels of blood glucose increased (p for trend<0.001). Significance: A higher circulatory concentration of ET-1 among DM subjects suggests possible endothelial dysfunction in this apparently healthy population. The relation between plasma ET-1 levels and DM needs further investigations aimed at defining the clinical predictive value of ET-1 in DM in the South Asian population.