Relationship Between Indices of Vascular Function and Presence of Overt Cardiovascular Disease Among Persons with Poorly Controlled Type 2 Diabetes

Overview

Journal J Cardiovasc Dev Dis

Specialty Cardiology & Vascular Diseases

Date 2021 Dec 23

PMID 34940540

Authors

Sofia Antoniou

Katerina K Naka

Marios Papadakis

Aris Bechlioulis

Dimitrios Makriyiannis

Agathocles Tsatsoulis

Lampros K Michalis

Stelios Tigas

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to assess the factors associated with impaired vascular function in patients with poorly controlled type 2 diabetes (DM2) with and without overt cardiovascular disease (CVD). Ninety-five patients with DM2 and poor glycemic control were recruited and divided into two groups: Group 1, with known CVD ( = 38), and Group 2, without CVD ( = 57). Patients in Group 2 were further subdivided into those with short (<5 years, group 2b) and long (>5 years, group 2a) diabetes duration. Subclinical markers of atherosclerosis were assessed. Glycemic control was similar in the two groups (HbA1c: 9.2% (1.5) vs. 9.4% (1.8), = 0.44). In Group 1, lower FMD (3.13 (2.16)% vs. 4.7 (3.4)%, < 0.05) and higher cIMT (1.09 (0.3) mm vs. 0.96 (0.2) mm, < 0.05) was seen compared with Group 2, whereas PWV was similar (12.1 (3.4) vs. 11.3 (3.0) m/s, = 0.10). Patients in Group 2b had significantly lower PWV and cIMT and higher FMD compared to Group 1 ( < 0.05). Among patients with poorly controlled T2D, more pronounced vascular dysfunction was present in those with overt macrovascular disease. In patients with T2D without known CVD, vascular dysfunction was associated with disease duration. The use of vascular indices for cardiovascular risk stratification in patients with T2D requires further study.

References

Nathan D . Long-term complications of diabetes mellitus. N Engl J Med. 1993; 328(23):1676-85. DOI: 10.1056/NEJM199306103282306. View

de Jager J, Dekker J, Kooy A, Kostense P, Nijpels G, Heine R . Endothelial dysfunction and low-grade inflammation explain much of the excess cardiovascular mortality in individuals with type 2 diabetes: the Hoorn Study. Arterioscler Thromb Vasc Biol. 2006; 26(5):1086-93. DOI: 10.1161/01.ATV.0000215951.36219.a4. View

Haffner S, Stern M, Hazuda H, Mitchell B, PATTERSON J . Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes?. JAMA. 1990; 263(21):2893-8. DOI: 10.1001/jama.263.21.2893. View

Arnold M, Mattle S, Galimanis A, Kappeler L, Fischer U, Jung S . Impact of admission glucose and diabetes on recanalization and outcome after intra-arterial thrombolysis for ischaemic stroke. Int J Stroke. 2012; 9(8):985-91. DOI: 10.1111/j.1747-4949.2012.00879.x. View

Munro J, COTRAN R . The pathogenesis of atherosclerosis: atherogenesis and inflammation. Lab Invest. 1988; 58(3):249-61. View

Lambadiari V, Pavlidis G, Kousathana F, Maratou E, Georgiou D, Andreadou I . Effects of Different Antidiabetic Medications on Endothelial Glycocalyx, Myocardial Function, and Vascular Function in Type 2 Diabetic Patients: One Year Follow-Up Study. J Clin Med. 2019; 8(7). PMC: 6678085. DOI: 10.3390/jcm8070983. View

Antoniou S, Naka K, Bechlioulis A, Papadakis M, Tsatsoulis A, Michalis L . Vascular effects following intensification of glycemic control in poorly controlled patients with long-standing type 2 diabetes mellitus. Hormones (Athens). 2021; 20(4):783-791. DOI: 10.1007/s42000-021-00318-x. View

Haffner S, Agostino Jr R, Saad M, OLeary D, Savage P, Rewers M . Carotid artery atherosclerosis in type-2 diabetic and nondiabetic subjects with and without symptomatic coronary artery disease (The Insulin Resistance Atherosclerosis Study). Am J Cardiol. 2000; 85(12):1395-400. DOI: 10.1016/s0002-9149(00)00784-0. View

Rana J, Liu J, Moffet H, Jaffe M, Karter A . Diabetes and Prior Coronary Heart Disease are Not Necessarily Risk Equivalent for Future Coronary Heart Disease Events. J Gen Intern Med. 2015; 31(4):387-93. PMC: 4803685. DOI: 10.1007/s11606-015-3556-3. View

10.

Stein J, Korcarz C, Hurst R, Lonn E, Kendall C, Mohler E . Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for.... J Am Soc Echocardiogr. 2008; 21(2):93-111. DOI: 10.1016/j.echo.2007.11.011. View

11.

Simova I, Denchev S, Dimitrov S, Ivanova R . Endothelial function in patients with and without diabetes mellitus with different degrees of coronary artery stenosis. J Clin Ultrasound. 2008; 37(1):35-9. DOI: 10.1002/jcu.20532. View

12.

Mitchell G . Arterial Stiffness and Wave Reflection: Biomarkers of Cardiovascular Risk. Artery Res. 2010; 3(2):56-64. PMC: 2705910. DOI: 10.1016/j.artres.2009.02.002. View

13.

Bots M, Westerink J, Rabelink T, de Koning E . Assessment of flow-mediated vasodilatation (FMD) of the brachial artery: effects of technical aspects of the FMD measurement on the FMD response. Eur Heart J. 2004; 26(4):363-8. DOI: 10.1093/eurheartj/ehi017. View

14.

Liye H, Lvyun Z, Guangyao S, Luping R . Investigation of early change of endothelial function and related factors in individuals with hyperglycemia. Diabetes Res Clin Pract. 2011; 92(2):194-7. DOI: 10.1016/j.diabres.2011.01.018. View

15.

OLeary D, Bots M . Imaging of atherosclerosis: carotid intima-media thickness. Eur Heart J. 2010; 31(14):1682-9. DOI: 10.1093/eurheartj/ehq185. View

16.

Corretti M, Anderson T, Benjamin E, Celermajer D, Charbonneau F, Creager M . Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002; 39(2):257-65. DOI: 10.1016/s0735-1097(01)01746-6. View

17.

Henry R, Kostense P, Spijkerman A, Dekker J, Nijpels G, Heine R . Arterial stiffness increases with deteriorating glucose tolerance status: the Hoorn Study. Circulation. 2003; 107(16):2089-95. DOI: 10.1161/01.CIR.0000065222.34933.FC. View

18.

Peiro C, Lorenzo O, Carraro R, Sanchez-Ferrer C . IL-1β Inhibition in Cardiovascular Complications Associated to Diabetes Mellitus. Front Pharmacol. 2017; 8:363. PMC: 5468794. DOI: 10.3389/fphar.2017.00363. View

19.

Cosentino F, Grant P, Aboyans V, Bailey C, Ceriello A, Delgado V . 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2019; 41(2):255-323. DOI: 10.1093/eurheartj/ehz486. View

20.

Tomiyama H, Hashimoto H, Hirayama Y, Yambe M, Yamada J, Koji Y . Synergistic acceleration of arterial stiffening in the presence of raised blood pressure and raised plasma glucose. Hypertension. 2005; 47(2):180-8. DOI: 10.1161/01.HYP.0000198539.34501.1a. View