Abstract :
Background: Atherosclerosis in patients with type 2 diabetes is multifactorial. Among other factors, dyslipidemia and increased levels of oxidized LDL are important pathogenic mechanisms of endothelial dysfunction in patients with diabetes. Non-invasive method of assessment of endothelial function by brachial artery flow-mediated vasodilatation (FMD), provided an extremely useful tool for clinical application.
Materials and Methods: 90 patients attending the medicine and endocrinology departments were included in the study. Informed consent was obtained from all the study subjects. Clinical examination: Blood pressure (BP) and body-mass index (BMI); biochemical assessment, which included fasting blood sugar (FBS) and post-prandial blood sugar levels; and comprehensive lipid profile. The brachial artery diameter was measured on B-mode ultrasound images. FMD was calculated. Severe endothelial dysfunction was defined as FMD < 4>
Results: The average FMD among controls was 14.76±2.17%, and among diabetics was 7.17±5.1%. Within the dyslipidemia subgroup, FMD was markedly reduced with an average dilatation of 5.74±5.02. Severe endothelial dysfunction was prevalent in 26% of the diabetics. Endothelial dysfunction could not be demonstrated in controls. Among patients with diabetic dyslipidemia, the prevalence of ED was 41%.
Conclusion: The present study findings may have implications about the origins of vascular disease in type 2 diabetes as well as patients with dyslipidemia. The ultrasound assessment of arterial FMD responses might provide a valuable tool for risk stratification of patients with type 2 diabetes, especially for those with dyslipidemia.
Keyword :
Endothelial dysfunction, Dyslipidemia, Diabetes, Arterial flow-mediated dilatation