Biological correlates of day-to-day variation in flow-mediated dilation in individuals with Type 2 diabetes: a study of test?retest reliability

West, Sheila G.; Wagner, Paul R; Schoemer, S. L.; Hecker, Kari D; Hurston, K. L.; Krick, Andrea Likos; Boseska, Linda; Ulbrecht, Jan S.; Hinderliter, Alan L.

doi:10.1007/s00125-004-1502-8

Cited by 43 publications

(43 citation statements)

References 31 publications

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“…In a recent report on variability of FMD (using a continuous method like we did) in type 2 diabetes, coefficients of variation for baseline diameter, peak diameter, and FMD were 2.7, 2.5, and 29.7%, respectively (29).…”

Section: Ultrasound Measurementsmentioning

confidence: 48%

The Effect of Statin Therapy on Endothelial Function in Type 2 Diabetes Without Manifest Cardiovascular Disease

et al. 2005

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OBJECTIVE -Cardiovascular disease (CVD) is the most important cause of mortality in patients with type 2 diabetes and is preceded by endothelial dysfunction. Flow-mediated dilation (FMD) is a noninvasive technique for measuring endothelial dysfunction. We aimed to determine the effect of long-term statin therapy versus placebo on FMD in patients with type 2 diabetes without manifest CVD. RESEARCH DESIGN AND METHODS-A randomized, placebo-controlled, doubleblind trial was performed with 250 type 2 diabetic patients. Patients were given 0.4 mg cerivastatin or placebo daily. In August 2001, when cerivastatin was withdrawn from the market, the 0.4 mg cerivastatin was replaced by 20 mg simvastatin, without deblinding the study. The primary end point was the change in FMD, measured by B-mode ultrasound, after 2 years.RESULTS -Determinants of baseline FMD were diabetes duration, common carotid intimamedia thickness, and brachial artery diameter. FMD at baseline was 1.51% in the placebo group and 1.66% in the statin group and did not change significantly after 2 years.CONCLUSIONS -The 2-year statin therapy had no effect on FMD in type 2 diabetes. Statin-induced improvement of cardiovascular risk in patients with type 2 diabetes may be mediated through mechanisms other than increased nitric oxide availability. Diabetes Care 28:1668 -1674, 2005C ardiovascular disease (CVD) is the most important cause of mortality in patients with type 2 diabetes (1). Endothelial dysfunction precedes the development of atherosclerotic plaques and is believed to be reversible (2). Nitric oxide (NO) is a key molecule in this process. It modulates blood flow and vascular permeability, limits inflammation and coagulation, and diminishes vascular smooth muscle cell proliferation and migration. Type 2 diabetes is associated with endothelial dysfunction; the underlying mechanisms are complex and related to hyperglycemia (sorbitol, hexosamine, protein kinase C, and advanced glycation end product pathways) and insulin resistance, resulting in mitochondrial superoxide overproduction and thus decreased NO availability (3). Regarding insulin, its vasodilatory capacity is at least in part NO dependent (4,5), thus explaining how insulin resistance might be related to endothelial dysfunction.Flow-mediated dilation (FMD) of the brachial artery is a noninvasive technique for measuring endothelial function. FMD of the brachial artery has been shown to be the result of endothelium-derived NO release (6) and is related to coronary vasoreactivity (7). FMD has proven to be predictive for the presence of coronary artery disease (8,9), for future cardiovascular events (10 -12), and for postoperative cardiovascular events (13) in high-risk populations. Improvement in FMD predicts a favorable cardiovascular outcome in postmenopausal hypertensive women (2). However, in patients at lower risk, FMD was not independently associated with outcome (14). FMD is impaired in patients with type 2 diabetes with reported FMD values of 4.47-12.3% in control subjects vs. 2.96 -6.1...

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Section: Ultrasound Measurementsmentioning

confidence: 48%

The Effect of Statin Therapy on Endothelial Function in Type 2 Diabetes Without Manifest Cardiovascular Disease

et al. 2005

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“…Assessment of vascular reactivity The ultrasound protocol closely followed recommendations by Corretti et al [26], and it has been described in detail previously [27]. Brachial arterial diameter and flow velocity were measured using an Acuson 128XP duplex ultrasound imaging system (Siemens, New York, NY, USA) with a 10-MHz linear array transducer.…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

Acute effects of monounsaturated fatty acids with and without omega-3 fatty acids on vascular reactivity in individuals with type 2 diabetes

et al. 2004

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Aims/hypothesis: We examined the acute postprandial effects of meals containing unsaturated fatty acids on flow-mediated dilation (FMD) of the brachial artery and triacylglycerols in individuals with type 2 diabetes. We hypothesised that consumption of omega-3 fatty acids would enhance vascular function. Saturated fat reduces FMD for several hours, but there is inconsistent evidence about whether foods containing unsaturated fats impair FMD acutely. Little is known about the acute effects of omega-3 fatty acids on vascular reactivity. Methods: We measured FMD before and 4 h after 3 test meals (50 g fat, 2,615 kJ) in 18 healthy adults with type 2 diabetes. The monounsaturated fatty acids (MUFA) meal contained 50 g fat from high oleic safflower and canola oils. Two additional meals were prepared by replacing 7% to 8% of MUFA with docosahexaenoic acid and eicosapentaenoic acid from sardine oil or α-linolenic acid from canola oil. Results: In the sample as a whole, FMD was increased 17% at 4 h vs. the fasting baseline. After the MUFA meal, subjects with the largest increases in triacylglycerols had the largest FMD decreases. The opposite pattern was observed after meals containing docosahexaenoic acid and eicosapentaenoic acid or α-linolenic acid. In subjects with high fasting triacylglycerols, meals containing 3 to 5 g of omega-3 fatty acids increased FMD by 50% to 80% and MUFA alone had no significant effects on FMD. Conclusions/ interpretation: Endothelium-dependent vasodilation was not impaired 4 h after meals containing predominantly unsaturated fatty acids. The fatty acid composition of the meal and the metabolic status of the individual determine the vascular effects of a high-fat meal.

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“…We chose patients with type 2 diabetes because they represent the majority of individuals with diabetes (Ͼ90%), and their number is continuously increasing (29), and because of their known susceptibility for cardiovascular complications (30). Sample size calculation was performed according to previous published data (31). Patients' characteristics were (means Ϯ SE): diabetes duration 9.6 Ϯ 2.5 years, BMI 30.3 Ϯ 0.9 kg/m 2 , HbA 1c (A1C) 8.5 Ϯ 0.5%, systolic blood pressure 136.5 Ϯ 6.0 mmHg, diastolic blood pressure 79.1 Ϯ 3.7 mmHg, heart rate 67.9 Ϯ 3.1/min, smokers/nonsmokers 3/10, 4 patients had nonproliferative retinopathy, 2 had nephropathy (microalbuminuria), 5 had peripheral neuropathy, and 10 had arterial hypertension.…”

Section: Diabetes Care 29:2064 -2071 2006mentioning

confidence: 99%

“…Although the number of studied subjects (n ϭ 13) is certainly not large, it allowed us to establish statistically significance to our results. Moreover, this sample size was based on calculations previously published (31).…”

Section: Correlationsmentioning

confidence: 99%

Benfotiamine Prevents Macro- and Microvascular Endothelial Dysfunction and Oxidative Stress Following a Meal Rich in Advanced Glycation End Products in Individuals With Type 2 Diabetes

et al. 2006

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OBJECTIVE -Diabetes is characterized by marked postprandial endothelial dysfunction induced by hyperglycemia, hypertriglyceridemia, advanced glycation end products (AGEs), and dicarbonyls (e.g., methylglyoxal [MG]). In vitro hyperglycemia-induced MG formation and endothelial dysfunction could be blocked by benfotiamine, but in vivo effects of benfotiamine on postprandial endothelial dysfunction and MG synthesis have not been investigated in humans until now.RESEARCH DESIGN AND METHODS -Thirteen people with type 2 diabetes were given a heat-processed test meal with a high AGE content (HAGE; 15.100 AGE kU, 580 kcal, 54 g protein, 17 g lipids, and 48 g carbohydrates) before and after a 3-day therapy with benfotiamine (1,050 mg/day). Macrovascular flow-mediated dilatation (FMD) and microvascular reactive hyperemia, along with serum markers of endothelial disfunction (E-selectin, vascular cell adhesion molecule-1, and intracellular adhesion molecule-1), oxidative stress, AGE, and MG were measured during both test meal days after an overnight fast and then at 2, 4, and 6 h postprandially.RESULTS -The HAGE induced a maximum reactive hyperemia decrease of Ϫ60.0% after 2 h and a maximum FMD impairment of Ϫ35.1% after 4 h, without affecting endotheliumindependent vasodilatation. The effects of HAGE on both FMD and reactive hyperemia were completely prevented by benfotiamine. Serum markers of endothelial dysfunction and oxidative stress, as well as AGE, increased after HAGE. These effects were significantly reduced by benfotiamine.CONCLUSIONS -Our study confirms micro-and macrovascular endothelial dysfunction accompanied by increased oxidative stress following a real-life, heat-processed, AGE-rich meal in individuals with type 2 diabetes and suggests benfotiamine as a potential treatment. Diabetes Care 29:2064 -2071, 2006E ndothelial dysfunction is an early marker of atherosclerosis and accompanies states showing a high cardiovascular risk, such as smoking (1), dyslipidemia (2), arterial hypertension (3), obesity (4), coronary artery disease (5), congestive heart failure (6), and type 1 (7) and type 2 (8) diabetes. Postprandial endothelial dysfunction has been proposed as the link between postprandial dysmetabolism and atherosclerosis (9) and occurs not only in patients with cardiovascular disease (10) or diabetes (11) but even in healthy subjects (12). Distinctive and cumulative (11) effects of hyperglycemia (13) and hypertriglyceridemia (14) on postprandial endothelial dysfunction have been shown. Since the postprandial state covers most of our daytime, interventions aimed at reducing postprandial endothelial dysfunction might play a decisive role in prevention of atherosclerosis. Several therapeutic approaches have been suggested for the treatment of postprandial endothelial dysfunction, including insulin, folic acid, tetrahydrobiopterin, vitamins C and E, and statins (11). These approaches aim at reducing postprandial oxidative stress (vitamins C and E, statins, and partly folic acid), postprandial hyperglycemia (insul...

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Biological correlates of day-to-day variation in flow-mediated dilation in individuals with Type 2 diabetes: a study of test?retest reliability

Cited by 43 publications

References 31 publications

The Effect of Statin Therapy on Endothelial Function in Type 2 Diabetes Without Manifest Cardiovascular Disease

The Effect of Statin Therapy on Endothelial Function in Type 2 Diabetes Without Manifest Cardiovascular Disease

Acute effects of monounsaturated fatty acids with and without omega-3 fatty acids on vascular reactivity in individuals with type 2 diabetes

Benfotiamine Prevents Macro- and Microvascular Endothelial Dysfunction and Oxidative Stress Following a Meal Rich in Advanced Glycation End Products in Individuals With Type 2 Diabetes

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