Vol 8, No 11 (2007): Practical Diabetology
Research paper
Published online: 2008-02-04
Intima-media thickness and selected parameters of endothelial function in patients with type 2 diabetes
Diabetologia Praktyczna 2007;8(11):397-404.
Abstract
INTRODUCTION. Type 2 diabetes (DM 2) is a growing
health and economic problem, mainly because
of development of its chronic complications. One of
possible mechanisms leading to their occurrence is
endothelial dysfunction (ED).
The aim of the study was to asses intima-media thickness
(IMT) and selected parameters of ED in patients
with DM 2. Specific aims were:
- assessment of IMT in DM 2 and in the controls;
- assessment of selected parameters of vasomotor and secretory function of endothelium in DM 2 patients and in the controls.
MATERIAL AND METHODS. We examined 182 patients with DM 2 from the outpatient clinic of Department of Metabolic Diseases, Jagiellonian University, Medical College. Diabetes was diagnosed according to WHO criteria. We included in our study DM 2 patients with at least 5 years diabetes duration, who were diagnosed after age 35 and were treated with oral hypoglycemic agents for at least 2 years. The control group included 43 healthy volunteers with normal fasting glucose level and correct result of oral glucose tolerance test according to WHO. All patients were examined and medical history was taken. We also measured IMT by ultrasound. We assessed endothelial function by
- flow-mediated dilatation (FMD) method;
- assessment of biochemical markers of ED - von Willebrand factor (vWf) and s-ICAM-1 (soluble intercellular adhesion molecule-1) concentrations. Statistical analysis included ANOVA analysis, Mann-Whitney’s test, χ2 test, calculation of Pearson’s linear correlation coefficient and multiple regression analysis.
RESULTS. We examined 182 patients with type 2 DM (mean age at the examination 56.3 yrs) including 91 (50%) women and 91 (50%) men together with 43 non-diabetic volunteers (mean age at the examination 55.4 years). Mean IMT was significantly higher and maximal FMD lower in DM 2 patients than in control group (respectively 0.83 mm vs. 0.66 mm; p < 0.00005 and 9.0% vs. 11.4%; p = 0.0165). No significant differences were found between groups in respect to s-ICAM-1 and vWf concentration. In multiple linear regression DM 2 was an independent predictor of increased IMT (p < 0.001). DM 2 did not appear to be a predictor of the other examined parameters: FMD as well as vWF and s-ICAM-1 levels.
CONCLUSIONS. DM 2 patients are characterized by the common occurence of increased IMT and endothelial vasodilation function. DM 2 is an independent predictor of intima-media thickening.
- assessment of IMT in DM 2 and in the controls;
- assessment of selected parameters of vasomotor and secretory function of endothelium in DM 2 patients and in the controls.
MATERIAL AND METHODS. We examined 182 patients with DM 2 from the outpatient clinic of Department of Metabolic Diseases, Jagiellonian University, Medical College. Diabetes was diagnosed according to WHO criteria. We included in our study DM 2 patients with at least 5 years diabetes duration, who were diagnosed after age 35 and were treated with oral hypoglycemic agents for at least 2 years. The control group included 43 healthy volunteers with normal fasting glucose level and correct result of oral glucose tolerance test according to WHO. All patients were examined and medical history was taken. We also measured IMT by ultrasound. We assessed endothelial function by
- flow-mediated dilatation (FMD) method;
- assessment of biochemical markers of ED - von Willebrand factor (vWf) and s-ICAM-1 (soluble intercellular adhesion molecule-1) concentrations. Statistical analysis included ANOVA analysis, Mann-Whitney’s test, χ2 test, calculation of Pearson’s linear correlation coefficient and multiple regression analysis.
RESULTS. We examined 182 patients with type 2 DM (mean age at the examination 56.3 yrs) including 91 (50%) women and 91 (50%) men together with 43 non-diabetic volunteers (mean age at the examination 55.4 years). Mean IMT was significantly higher and maximal FMD lower in DM 2 patients than in control group (respectively 0.83 mm vs. 0.66 mm; p < 0.00005 and 9.0% vs. 11.4%; p = 0.0165). No significant differences were found between groups in respect to s-ICAM-1 and vWf concentration. In multiple linear regression DM 2 was an independent predictor of increased IMT (p < 0.001). DM 2 did not appear to be a predictor of the other examined parameters: FMD as well as vWF and s-ICAM-1 levels.
CONCLUSIONS. DM 2 patients are characterized by the common occurence of increased IMT and endothelial vasodilation function. DM 2 is an independent predictor of intima-media thickening.