A new early diagnostic criterion for endothelial dysfunction in men

Abstract

Endothelial dysfunction (ED) triggers vascular complications in many diseases, including diabetes mellitus. Currently existing methods for detection of ED do not ensure early diagnostics of the pathological process. We examined 168 men with type 2 diabetes mellitus. ED was studied by ultrasound assessment of arterial vasoreactivity of the brachial artery and determination of biochemical ED markers. Based on manifestations of reactive hyperemia, the patients were divided into groups according to the presence or absence of ED. It was shown that 23.2%of the patients exhibiting normal endothelium-dependent vasodilation in response to the reactive hyperemia test had s.582 + 353_379del polymorphism of the endothelial nitric oxide synthase gene. We also demonstrated that the time till maximum vasodilatation in these patients was 33.3% longer, on the average, than in men who did not have such polymorphism. The slowdown of the maximum response of endothelium-dependent vasodilation was associated with increased levels of ED proteomic markers VCAM-1 and ICAM-1 in 27% and 22.9% of the cases respectively. Thus, we showed for the first time that the time till maximum vasodilation is a more reliable marker of ED than the difference between the diameters of the brachial artery during reactive hyperemia test expressed in percentage.