Type 2 diabetes is associated with impaired endothelium-dependent, flow-mediated dilation, but impaired glucose metabolism is not: the Hoorn Study

Henry, Ronald M.A., Ferreira, Isabel, Kostense, Piet J., Dekker, Jacqueline M., Nijpels, Giel, Heine, Robert J., Kamp, Otto, Bouter, Lex M. and Stehouwer, Coen D.A. (2004) Type 2 diabetes is associated with impaired endothelium-dependent, flow-mediated dilation, but impaired glucose metabolism is not: the Hoorn Study. Atherosclerosis, 174 1: 49-56. doi:10.1016/j.atherosclerosis.2004.01.002


Author Henry, Ronald M.A.
Ferreira, Isabel
Kostense, Piet J.
Dekker, Jacqueline M.
Nijpels, Giel
Heine, Robert J.
Kamp, Otto
Bouter, Lex M.
Stehouwer, Coen D.A.
Title Type 2 diabetes is associated with impaired endothelium-dependent, flow-mediated dilation, but impaired glucose metabolism is not: the Hoorn Study
Journal name Atherosclerosis   Check publisher's open access policy
ISSN 0021-9150
1879-1484
Publication date 2004-05
Sub-type Article (original research)
DOI 10.1016/j.atherosclerosis.2004.01.002
Open Access Status Not yet assessed
Volume 174
Issue 1
Start page 49
End page 56
Total pages 8
Place of publication E Park, Shannon, Clare Ireland
Publisher Elsevier Ireland
Language eng
Formatted abstract
Background: Type 2 diabetes (DM2) and impaired glucose metabolism (IGM) are associated with an increased cardiovascular disease risk. Impaired endothelial synthesis of nitric oxide (NO) is an important feature of atherothrombosis and can be estimated from endothelium-dependent flow-mediated dilation (FMD). It is controversial whether or not FMD is impaired in DM2 and IGM. We investigated this issue in a population-based setting.

Methods and results: In the study population (n = 650; 246 with normal glucose metabolism (NGM), 135 with IGM and 269 with DM2; mean age: 67.6 years), FMD and endothelium-independent nitroglycerine-mediated dilation (NMD) were ultrasonically estimated from the brachial artery and expressed as the absolute change in diameter in mm. The increase in diameter (mean ± standard deviation) in NGM, IGM and DM2 was 0.19±0.15, 0.19±0.18 and 0.13±0.17 for FMD and 0.45±0.21, 0.43±0.24 and 0.45±0.25 for NMD. After adjustment for age, sex, baseline diameter and percentage increase in peak systolic velocity, DM2, as compared to NGM, remained associated with impaired FMD (regression coefficient β (95%CI)) as compared to NGM, -0.06 mm (-0.09 to -0.03). IGM was not associated with impaired FMD (β, 0.01 mm (-0.02 to 0.04)). Additional adjustment for conventional cardiovascular risk factors did not alter these associations. Hyperglycemia or hyperinsulinemia explained 2% of the association between DM2 and FMD. NMD was not associated with glucose tolerance.

Conclusions: This study shows that DM2 is independently associated with impaired FMD. Hyperglycemia and hyperinsulinemia contribute minimally to this association. Impaired FMD may therefore, in part, explain the increased cardiovascular disease risk in DM2, whereas the normal FMD in IGM suggests that other forms of endothelial dysfunction are important in explaining the increased cardiovascular disease risk in IGM.
Keyword Epidemiology
Flow-mediated dilation
Nitric oxide
Type 2 diabetes
Ultrasound
Vascular biology
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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