Why the study?
Endothelial function in elderly patients with noninsulin-dependent diabetes mellitus (NIDDM) was compared noninvasively to understand vascular impairment.
Meta-Analysis
Endothelial impairment in elderly type 2 diabetes signals vascular risk; leaves open whether routine FMD improves stratification or outcomes.
We compared endothelial function noninvasively in 15 elderly patients with noninsulin-dependent diabetes mellitus (NIDDM) with 12 nondiabetic elderly patients. Using high resolution ultrasound, we measured flow-mediated dilatation (FMD) of the brachial artery and sublingual nitroglycerin (NTG)-mediated dilatation. FMD was significantly impaired in subjects with NIDDM compared with control subjects. In NIDDM subjects, FMD with complications was lower than in subjects with noncomplications. However, there was no significant difference in NTG between NIDDM subjects and the control group. Hyperemic blood flow change was lower in NIDDM subjects, but not significant. These results suggest that elderly patients with NIDDM have impaired L-arginine/nitric oxide (NO) pathways and the possibility of capillary rarefaction.
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Kimura et al. (2001) conducted a meta-analysis in Type 2 Diabetes. Type 2 diabetes vs. Healthy controls was evaluated on Endothelium-dependent vascular smooth muscle relaxation (response to acetylcholine/methacholine) (WMD -39.2%, 95% CI -46.0, -33.5, p=<0.001).
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