Reduced venous endothelial responsiveness after oral lipid overload in healthy volunteers

Signori

Plentz

et al. 2008

Braz J Med Biol Res

The objective of the present study was to determine the acute effect of hemodialysis on endothelial venous function and oxidative stress. We studied 9 patients with end-stage renal disease (ESRD), 36.8 ± 3.0 years old, arterial pressure 133.8 ± 6.8/80.0 ± 5.0 mmHg, time on dialysis 55.0 ± 16.6 months, immediately before and after a hemodialysis session, and 10 healthy controls matched for age and gender. Endothelial function was assessed by the dorsal hand vein technique using graded local infusion of acetylcholine (endothelium-dependent venodilation, EDV) and sodium nitroprusside (endothelium-independent venodilation). Oxidative stress was evaluated by measuring protein oxidative damage (carbonyls) and antioxidant defense (total radical trapping antioxidant potential -TRAP) in blood samples. All patients were receiving recombinant human erythropoietin for at least 3 months and were not taking nitrates or α-receptor antagonists. EDV was significantly lower in ESRD patients before hemodialysis (65.6 ± 10.5) vs controls (109.6 ± 10.8; P = 0.010) and after hemodialysis (106.6 ± 15.7; P = 0.045). Endotheliumindependent venodilation was similar in all comparisons performed. The hemodialysis session significantly decreased TRAP (402.0 ± 53.5 vs 157.1 ± 28.3 U Trolox/µL plasma; P = 0.001). There was no difference in protein damage comparing ESRD patients before and after hemodialysis. The magnitude of change in the EDV was correlated negatively with the magnitude of change in TRAP (r = -0.70; P = 0.037). These results suggest that a hemodialysis session improves endothelial venous function, in association with an antioxidant effect.

Section: Dorsal Hand Vein Techniquementioning

confidence: 99%

Hemodialysis improves endothelial venous function in end-stage renal disease

Signori

Plentz

et al. 2008

Braz J Med Biol Res

“…Both hyperglycemia21 and high blood pressure levels22 can interfere with endothelial-dependent vasodilation. Although these factors were under control, there was still venous endothelial dysfunction in all of the patients in the group as compared to non-diabetic subjects, who showed 105.8% ± 9.5% of endothelium-dependent vasodilation in a previous study carried out by our group 10. There were no differences between the groups studied except for the use of insulin, indicating that the subcutaneous use of insulin does not interfere with venous endothelial function, as was previously shown for arterial endothelium evaluation 23.…”

Section: Discussionmentioning

confidence: 64%

“…Venous endothelial function was assessed in all patients via the dorsal hand vein technique, 11 a method for which our group has published details elsewhere 10,12,13. Briefly, a 23-gauge butterfly needle was inserted into a suitable vein on the back of the hand, and a continuous infusion of physiologic saline solution (0.3 mL/min) was started.…”

Section: Methodsmentioning

confidence: 99%

“…It is not known if the treatment of diabetic patients with subcutaneous insulin can interfere with the evaluation of endothelial function. No existing studies have evaluated the possible effect of subcutaneous insulin use on venous endothelial function, a method that, in some instances, can be more sensitive to subtle endothelial abnormalities 10. The aim of this study was to compare endothelium-dependent dilation in patients with type 2 DM with good metabolic and blood pressure control according to whether they used insulin as part of their therapy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Insulin Therapy does not Interfere with Venous Endothelial Function Evaluation in Patients with Type 2 Diabetes Mellitus

Penno

Bertoluci

et al. 2010

Clinics

Self Cite

INTRODUCTION:Endothelium-dependent dilation is improved in insulin-treated diabetic patients, but this effect is probably due to improved glycemic control. The objective of the present study was to compare endothelium-dependent dilation in patients with well-controlled type 2 diabetes who are or are not using insulin as part of their therapy.METHODS:We studied 27 patients with type 2 diabetes (11 women, 60.3 years ± 6 years, with HbA1c < 7% and no nephropathy), including 16 patients treated with anti-diabetic agents (No-Ins, 8 women) and 11 patients treated with insulin alone or in combination with anti-diabetic agents (Ins, 3 women). Endothelial function was evaluated by the dorsal hand vein technique, which measures changes in vein diameter in response to phenylephrine, acetylcholine (endothelium-dependent vasodilation) and sodium nitroprusside (endothelium-independent vasodilation).RESULTS:Age, systolic blood pressure (No-Ins: 129.4 mmHg ± 11.8 mmHg, Ins: 134.8 mmHg ± 12.0 mmHg; P = 0.257), HbA1c, lipids and urinary albumin excretion rate [No-Ins: 9 mg/24 h (0-14.1 mg/24 h) vs. Ins: 10.6 mg/24 h (7.5-14.4 mg/24 h), P = 0.398] were similar between groups. There was no difference between endothelium-dependent vasodilation of the No-Ins group (59.3% ± 26.5%) vs. the Ins group (54.0% ± 16.3%; P = 0.526). Endothelium-independent vasodilation was also similar between the No-Ins (113.7% ± 35.3%) and Ins groups (111.9% ± 28.5%; P = 0.888).CONCLUSIONS:Subcutaneous insulin therapy does not interfere with venous endothelial function in type 2 diabetes when glycemic and blood pressure control are stable.

“…A técnica de complacência da veia dorsal da mão é um método minimamente invasivo, descrito por Aellig em 1981 (29) e recentemente utilizada por nosso grupo (30). Consiste na infusão de drogas vasoativas em uma veia superficial do dorso da mão, somente com efeitos locais, para mensurar a vasodilatação dependente do endotélio em resposta a acetilcolina, bradicinina ou isoprenalina.…”

Section: Endotélio Normal E Deunclassified

Disfunção endotelial no diabetes melito tipo 1

Bertoluci

Cé

Arq Bras Endocrinol Metab

et al. 2008

As complicações vasculares são a maior causa de morbimortalidade em pacientes com diabetes. Os mecanismos envolvidos no desenvolvimento das doenças micro e macrovasculares são complexos e parcialmente compreendidos, mas se iniciam invariavelmente por um endotélio que se torna disfuncionado. O óxido nítrico é um importante regulador da função endotelial e o comprometimento da sua atividade é fator determinante para a disfunção endotelial (DE). No diabetes tipo 1, diversos fatores, como a hiperglicemia aguda, mau controle glicêmico crônico, tempo de diagnóstico e presença de neuropatia autonômica ou microalbuminúria estão associados à DE. Tanto o estresse oxidativo, como a ativação da via dos polóis, via da proteína quinase C e formação dos produtos avançados de glicação não-enzimática são potenciais mecanismos patogenéticos da DE. A detecção precoce da disfunção endotelial tem valor prognóstico para o desenvolvimento de complicações vasculares e pode ser importante em estratégias de prevenção primária de eventos cardiovasculares no diabetes tipo 1.