Assessment of endothelial function by flow-mediated dilation in diabetic patients: Effects of physical exercise

Abstract

Abstract--The endothelium is now recognized as an endocrine organ that acts to maintain vascular homeostasis regulating the vascular tone and structure. The endothelial cells synthetize a variety of mediators among them, the main agent is the nitric oxide (NO), a potent vasodilator. NO exerts its protective role preventing leukocyte adhesion and migration, expression of adhesion molecules, platelet aggregation, cell proliferation, and promoting the relaxation of smooth muscle cells. On the other hand, endothelial dysfunction present in many chronic diseases such as atherosclerosis, coronary artery disease, peripheral artery disease, hypertension and diabetes mellitus, is characterized by reduced NO bioavailability. Thus, a few decades ago, measurement of endothelial function has emerged as valuable tool that provides insights in the pathophysiological mechanisms, opportunity to identify early disease and cardiovascular risk, preventing future events or avoiding the progression of the disease. Diabetic patients, particularly, have been a target to apply this technique, mainly because this condition has been related with an impairment of endothelium-dependent dilation and it is believed that the endothelium dysfunction is the basis of diabetes complications such as coronary artery disease and accelerated atherosclerosis. In addition, cardiovascular complications represent the leading cause of morbidity and death in diabetes mellitus. Besides pharmacological therapy, lifestyle modifications have been recommended by specific organizations as a strategy to improve the endothelial function or even prevent the development of diabetes. The aim of this mini eview is to give an update about the importance of endothelium, most common non-invasive technique to evaluate its function, and to summarize some mechanisms involved in endothelial dysfunction and the beneficial effects of exercise in diabetes mellitus.

Pharmacological effects of statins in adult patients with type 2 diabetes mellitus: A protocol for systematic review and meta-analysis

“…[ 10 ] T2D is associated with reduced flow-mediated dilatation (FMD), [ 11 ] a noninvasive approach for the assessment of endothelial function. [ 12 , 13 ] However, its impairment suggests an imbalanced production of vasodilators, hence endothelial dysfunction.…”

Association between Flow-Mediated Dilation and Skin Perfusion Pressure with Peripheral Artery Disease in Hemodialysis Patients

“…It is expressed as percentage change of the arterial diameter from the baseline diameter [8]. FMD has been used in both clinical research and clinical practice [9], and it has been shown to be strongly predictive of future CV events in patients with diabetes mellitus (DM) [10]. Moreover, two previous studies have demonstrated impaired FMD in patients with endstage renal disease [11,12].…”

Influência Da Fisioterapia Aquática Na Flexibilidade De Idosos Hipertensos E Diabeticos

“…A Diabetes Mellitus é a ausência de insulina ou inaptidão da insulina de exercer corretamente sua função, tem como característica a hiperglicemia crônica e mudanças no metabolismo dos carboidratos proteínas e lipídeos, uma hiperglicemia prolongada é bastante nociva ao organismo, pois pode desenvolver lesões orgânicas irreversíveis causando danos aos rins, aos olhos, aos nervos, aos pequenos e grandes vasos, danos teciduais, perda de função e falência de vários órgãos (JARRETE; ZANESCO; DELBIN, 2016;SÁ;NAVAS;ALVES, 2014).…”