Key result
In individuals with type 2 diabetes, microalbuminuria was significantly associated with lower flow-mediated dilation, higher intima-media thickness, and higher pulse-wave velocity compared to normoalbuminuria (p<0.001 for all).
Cross-Sectional (n=158)
No
p-value: p=<0.001
In patients with type 2 diabetes, endothelial dysfunction (impaired FMD) is independently associated with microalbuminuria and correlates with early structural atherosclerotic changes.
May signal heightened vascular risk in T2DM; hypothesis-generating and requires prospective validation before guiding care.
AIMS: To investigate whether endothelial dysfunction assessed by brachial artery flow-mediated dilation (FMD) is associated with urinary albumin excretion (UAE) and is interrelated with carotid intima-media thickness (IMT) and pulse-wave velocity (PWV) in type 2 diabetes. METHODS: We measured FMD, IMT and PWV in 158 subjects with type 2 diabetes (normo- 49, micro- 64, macroalbuminuria 45), explored the determinants of FMD, and analyzed the relationship of FMD with traditional cardiovascular risk factors according to IMT and PWV levels. RESULTS: Microalbuminuria was significantly associated with lower FMD, higher IMT and higher PWV compared to normoalbuminuria (p < 0.001 for all). FMD was significantly correlated with IMT and PWV, and also with traditional risk factors, UAE, glomerular filtration rate, diabetic retinopathy, and neuropathy. Multivariate regression analysis revealed that UAE remained a significant determinant of FMD independent of traditional risk factors, metabolic control, and renal function. The relationship of FMD with IMT and PWV was less pronounced in subjects with increased IMT and PWV. CONCLUSIONS: In individuals with type 2 diabetes, FMD is impaired in subjects with microalbuminuria and is associated with IMT and PWV only when these values are not increased, i.e., at an early stage of atherosclerosis.
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Yokoyama et al. (2011) conducted a cross-sectional in Type 2 diabetes (n=158). Microalbuminuria vs. Normoalbuminuria was evaluated on Flow-mediated dilation (FMD), intima-media thickness (IMT), and pulse-wave velocity (PWV) (p=<0.001). In individuals with type 2 diabetes, microalbuminuria was significantly associated with lower flow-mediated dilation, higher intima-media thickness, and higher pulse-wave velocity compared to normoalbuminuria (p<0.001 for all).
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