Endothelial function in individuals with coronary artery disease with and without type 2 diabetes mellitus

Abstract

Aim and Hypothesis-The goal of this study was to determine if individuals with coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM) had greater endothelial dysfunction (ED) than individuals with only CAD.Methods-Flow mediated dilation (FMD), calculated as percentage increase in brachial artery diameter in response to post-ischemic blood flow, was measured after an overnight fast in two cohorts. The first cohort included 76 participants in the Northern Manhattan Study (NOMAS) with CAD; 25 also had T2DM. The second cohort was composed of 27 individuals with both T2DM and CAD who were participants in a study of postprandial lipemia. Combined, we analyzed 103 patients with CAD; 52 with T2DM (T2DM+) and 51 without T2DM (T2DM−).Results-The 52 CAD T2DM+ subjects had a mean FMD of 3.9 ± 3.2%, while the 51 CAD T2DM− subjects had a greater mean FMD of 5.5 ± 4.0% (P<0.03). An investigating of various confounders known to affect FMD identified age and BMI as the only significant covariates in a multiple regression model. Adjusting for age and BMI, we found that FMD remained lower in T2DM+ subjects compared to T2DM− subjects (difference −1.99%, P<0.03).Interpretation/Conclusion-In patients with CAD, the concomitant presence of T2DM is independently associated with greater ED, as measured by FMD. This finding may be relevant to the greater early and late morbidity and mortality observed in patients with both CAD and T2DM.

The endothelial dysfunction in patients with type 2 diabetes mellitus is associated with IL-6 gene promoter polymorphism in Chinese population

“…Previous studies have shown chronic low-grade inflammation which features obese, insulin resistance, and T2DM plays a central role in the pathogenesis of ED [4,5,29,30], our data also show remarkable ED in patients with T2DM that indicated by decreased FMD, a non-invasive detection technique first described by Celermajer et al [31]. As ED is one of the earliest events predicting the onset of overt CAD [2], with worse ED, there is a higher risk of concomitant CAD in T2DM patients.…”

“…In the process of CAD initiation and development, the endothelial dysfunction (ED) is an early event and predate the clinical evidence of CAD for many years [2,3]. ED also can be found in patients with T2DM [4], and is further deteriorated in T2DM patients concomitant with CAD [5]. ED could be a pathological state linking T2DM and CAD, and even potentially plays a causative role on initiation and development of CAD [3].…”

The glycocalyx and its significance in human medicine

“…In diabetic individuals, it has been observed that atherosclerosis is distributed more uniformly in arteries, not following the typical association with regions of low shear or disturbed flow near bifurcations and curvatures [57]. In addition, vasodilation is altered in diabetes [58]. All of these observations imply a fundamental difference in mechanotransduction by the ECs of diabetic individuals that may be explained in part by alterations in the GCX.…”

Predictive role of circulating endothelial-derived microparticles in cardiovascular diseases

“…Therefore, the high burden of cardiovascular and metabolic risk factors in different countries may have affected the increased incidences of Clinical Biochemistry xxx (2015) xxx-xxx death in subjects prior to the documentation of cardiovascular diseases [2][3][4]. The endothelium is considered an important target for traditional risk factors and endothelial dysfunction remained independently associated with cardiovascular mortality [5][6][7]. Although endothelial dysfunction is an early event in the development and progression of cardiovascular disease and biological markers of endothelial dysfunction are abundant, there remains no ideal indicator which covers the several faces of pathogenesis of cardiovascular disease and improves patient stratification at risk and individualizing treatment strategy [8].…”