The authors declare that they have no competing interest.
KKN participated in the overall design, statistical analysis, data interpretation, writing and presentation of this work. KP participated in the overall design and conduct of the study, data collection and drafted portions of the manuscript. AB performed statistical analysis and contributed to the interpretation of data, writing and presentation of this work. NK participated in data collection, data collection and drafted portions of the manuscript. KP participated in the design of the study, data interpretation and critically revised the manuscript before final approval. ST participated in data interpretation and critically revised the manuscript before final approval. DM participated in study design, data collection and data interpretation. AT participated in study design, data collection, data interpretation and critically revised the manuscript before final approval. LKM supervised the design and conduction of the study, participated in data interpretation and critically revised the manuscript before final approval. All authors read and approved the final manuscript.
Type 2 diabetes mellitus (T2DM) is independently associated with an increased risk for cardiovascular diseases that is primarily due to the early development of advanced atherosclerotic vascular changes. The aim of our study was to investigate the predictors of vascular dysfunction in T2DM patients.
We studied 165 T2DM patients without known macrovascular or microvascular disease. Standard demographic (age, gender, cardiovascular risk factors, medications), clinical (body mass index, blood pressure) and laboratory (glucose, glycated hemoglobin, lipids, renal function) parameters were included in analyses. Brachial artery flow-mediated dilation (FMD), nitrate mediated dilation (NMD) and Carotid-Femoral Pulse Wave Velocity (PWV) were measured.
Median age was 66 years and duration since T2DM diagnosis was 10 years, 70% were females and 79% hypertensives, while only 10% had a glycated hemoglobin <7%. FMD was positively associated with NMD (r 0.391, P < 0.001), while PWV was inversely associated with FMD (r -0.218, P = 0.014) and NMD (r -0.309, P < 0.001). Time since diagnosis of diabetes was the single independent predictor of FMD (β -0.40, P = 0.003). Increased age and fasting glucose and the presence of hypertension were independent predictors of decreased NMD (P < 0.001). Increased age and systolic blood pressure were independently associated with increased PWV (P < 0.001).
In T2DM patients, impairment of endothelium-dependent vasodilation was independently associated only with longer diabetes duration while no association with other established risk factors was found. Vascular smooth muscle dysfunction and increased arterial stiffness were more prominent in older T2DM patients with hypertension. Worse glycemic control was associated with impaired vascular smooth muscle function.
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- Determinants of vascular function in patients with type 2 diabetes
Katerina K Naka
Lampros K Michalis
- BioMed Central
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