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Characterization of macro-and microvascular function and structure in patients with type 2 diabetes mellitus

Keymel, Stefanie, Heinen, Yvonne, Balzer, Jan, Rassaf, Tienush, Kelm, Malte, Lauer, Thomas and Heiss, Christian (2011) Characterization of macro-and microvascular function and structure in patients with type 2 diabetes mellitus American Journal of Cardiovascular Research, 1 (1). pp68-75.

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Abstract

Objective: Diabetes mellitus (DM) leads to accelerated progression of arteriosclerosis with an increased risk of coronary events in comparison to non-diabetic patients with coronary artery disease (CAD). The precise and early detection of DM-induced vascular alterations is crucial to identify patients with high risk for cardiovascular complications. Thus, we aimed at simultaneously characterizing functional, physicomechanical, and structural vascular alterations in diabetic patients using a non-invasive approach. Research Design and Methods: In CAD patients with and without type 2 diabetes mellitus (n=50), we non-invasively measured flow-mediated dilation (FMD) of the brachial artery as a marker for endothelial function, fractional diameter changes (FDC) as a marker for physicomechanical properties, intima-media thickness (IMT) as a marker for structural properties, and forearm blood flow (FBF) as a marker for microvascular function. Results: DM was associated with reduced FMD (2.5±0.2 vs 4.8±0.4%; p≤0.001) indicating impaired macrovascular endothelial function. In parallel, reduced FDC (0.024±0.002 vs 0.034±0.004; p≤0.05) and increased IMT (0.38±0.01 vs 0.31±0.01mm; p≤0.001) indicated increased stiffness and enhanced structural alterations. Furthermore, reduced forearm blood flow during reactive hyperemia (10.7±1.0 vs. 15.3±1.4mL/min*100mL; p≤0.05) was found indicating microvascular dysfunction. Plasma glucose and HbA1c correlated with FMD (glucose: r=-0.32; HbA1c: r=-0.45), IMT (glucose: r=0.54; HbA1c: r=0.48) and FBF (glucose: r=-0.30) suggesting diabetes-specific effects on vascular properties. Conclusion: In patients with CAD, DM leads to functional and structural vascular alterations of the peripheral vasculature which are determined by the control of the disease underlining the relevance of a strict control of the DM to prevent accelerated atherosclerosis.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine > Department of Clinical and Experimental Medicine
Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Faculty of Health and Medical Sciences
Authors :
NameEmailORCID
Keymel, Stefanie
Heinen, Yvonne
Balzer, Jan
Rassaf, Tienush
Kelm, Malte
Lauer, Thomas
Heiss, Christianc.heiss@surrey.ac.uk
Date : 15 May 2011
Copyright Disclaimer : AJCD Copyright © 2011
Uncontrolled Keywords : Diabetes mellitus; Coronary artery disease; Endothelial function; Intima media thickness; Microcirculation
Depositing User : Diane Maxfield
Date Deposited : 16 Aug 2018 10:04
Last Modified : 16 Aug 2018 10:04
URI: http://epubs.surrey.ac.uk/id/eprint/848971

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