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Dal S, Sigrist S. The Protective Effect of Antioxidants Consumption on Diabetes and Vascular Complications. Diseases 2016; 4:E24. [PMID: 28933404 PMCID: PMC5456287 DOI: 10.3390/diseases4030024] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/20/2016] [Accepted: 06/23/2016] [Indexed: 12/14/2022] Open
Abstract
Obesity and diabetes is generally accompanied by a chronic state of oxidative stress, disequilibrium in the redox balance, implicated in the development and progression of complications such as micro- and macro-angiopathies. Disorders in the inner layer of blood vessels, the endothelium, play an early and critical role in the development of these complications. Blunted endothelium-dependent relaxation and/or contractions are quietly associated to oxidative stress. Thus, preserving endothelial function and oxidative stress seems to be an optimization strategy in the prevention of vascular complications associated with diabetes. Diet is a major lifestyle factor that can greatly influence the incidence and the progression of type 2 diabetes and cardiovascular complications. The notion that foods not only provide basic nutrition but can also prevent diseases and ensure good health and longevity is now attained greater prominence. Some dietary and lifestyle modifications associated to antioxidative supply could be an effective prophylactic means to fight against oxidative stress in diabesity and complications. A significant benefit of phytochemicals (polyphenols in wine, grape, teas), vitamins (ascorbate, tocopherol), minerals (selenium, magnesium), and fruits and vegetables in foods is thought to be capable of scavenging free radicals, lowering the incidence of chronic diseases. In this review, we discuss the role of oxidative stress in diabetes and complications, highlight the endothelial dysfunction, and examine the impact of antioxidant foods, plants, fruits, and vegetables, currently used medication with antioxidant properties, in relation to the development and progression of diabetes and cardiovascular complications.
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Affiliation(s)
- Stéphanie Dal
- DIATHEC EA 7294 UMR Centre Européen d'Etude du Diabète (CeeD), Université de Strasbourg (UdS), boulevard René Leriche, Strasbourg 67200, France.
| | - Séverine Sigrist
- DIATHEC EA 7294 UMR Centre Européen d'Etude du Diabète (CeeD), Université de Strasbourg (UdS), boulevard René Leriche, Strasbourg 67200, France.
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Jarrete AP, Zanesco A, Delbin MA. Assessment of endothelial function by flow-mediated dilation in diabetic patients: Effects of physical exercise. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-65742016000100001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Angelina Zanesco
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Brazil
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Lu B, Zhao M, Jiang W, Ma J, Yang C, Shao J, Gu P. Independent Association of Circulating Level of Chemerin With Functional and Early Morphological Vascular Changes in Newly Diagnosed Type 2 Diabetic Patients. Medicine (Baltimore) 2015; 94:e1990. [PMID: 26632694 PMCID: PMC5058963 DOI: 10.1097/md.0000000000001990] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
There is growing evidence that chemerin, a novel adipokine elevated in obesity and metabolic syndromes, plays a crucial role in advanced atherosclerosis. This study aimed to determine the chemerin levels in diabetes and evaluate the effects of increased chemerin on early atherosclerosis.A total of 245 newly diagnosed diabetic patients and 148 age-matched, healthy, normal glucose tolerant (NGT) controls were enrolled. Anthropometric measurements and plasma parameters were examined, including body mass index (BMI), waist circumference, blood pressure, glucose, lipid profiles, inflammation markers, adipokines, and cell adhesion molecules. Vascular healthy was measured with brachial flow-mediated dilatation (FMD) and carotid intima-media thickness (IMT).Compared with NGT controls, plasma chemerin levels were higher in diabetic patients (P < 0.01) and higher chemerin level was an independent risk factor of occurrence of diabetes even after metabolic profiles were adjusted (odds ratio [OR] = 1.352, 95% CI: 1.181-1.543, P < 0.01). In patients with type 2 diabetes, chemerin was positively associated with intercellular adhesion molecule-1 (ICAM-1), E-selectin, but not vascular adhesion molecule-1 (VCAM-1) and P-selectin. We also explored that plasma chemerin level was negatively associated with brachial FMD and positively with carotid IMT. Chemerin also retained a strong association with ICAM-1, FMD, and IMT even after adjusted for age, sex, and other risk factors (ICAM-1: r = 0.150, P = 0.024; FMD: r = -0.126, P = 0.001; IMT: r = 0.325, P < 0.001). By multiple linear regression analysis, plasma chemerin levels were related to ICAM-1 even after adjustments for conventional cardiovascular risk factors (β = 0.192, P = 0.017). Moreover, logistic regression analysis showed that high chemerin level was an independent predictive variable for impaired endothelial function (OR = 1.066, 95% CI: 1.012-1.142, P = 0.048) and enhanced carotid vessel thickness (OR = 1.068, 95% CI: 1.021-1.148, P = 0.035) in diabetic patients.In summary, chemerin levels are independently associated with endothelial activation and early atherosclerosis in newly diagnosed type 2 diabetes.
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Affiliation(s)
- Bin Lu
- From the Department of Endocrinology, Jinling Hospital/Nanjing General Hospital of Nanjing Military Command, Nanjing University School of Medicine (BL, MZ, JM, CY, JS, PG); and Department of Cardiology, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu Province, P.R. China (WJ)
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54
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van Moorsel D, van Greevenbroek MMJ, Schaper NC, Henry RMA, Geelen CC, van Rossum EFC, Nijpels G, 't Hart LM, Schalkwijk CG, van der Kallen CJH, Sauerwein HP, Dekker JM, Stehouwer CDA, Havekes B. BclI glucocorticoid receptor polymorphism in relation to cardiovascular variables: the Hoorn and CODAM studies. Eur J Endocrinol 2015; 173:455-64. [PMID: 26139210 DOI: 10.1530/eje-15-0381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/02/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Excess glucocorticoids are known to cause hypertension and cardiovascular disease (CVD). The BclI glucocorticoid receptor (GR) polymorphism increases glucocorticoid sensitivity and is associated with adverse metabolic effects. Previous studies investigating cardiovascular implications have shown inconsistent results. Therefore, the aim of the present study was to investigate the association of the BclI polymorphism with blood pressure, atherosclerosis, low-grade inflammation, endothelial dysfunction, and prevalent CVD. DESIGN Observational cohort study, combining two cohort studies designed to investigate genetic and metabolic determinants of CVD. METHODS We genotyped 1228 individuals (aged 64.7 years±8.5) from the Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) study and Hoorn study for the BclI polymorphism. We measured blood pressure, ankle-brachial index (ABI), and carotid intima-media thickness (cIMT). Low-grade inflammation and endothelial dysfunction scores were computed by averaging Z-scores of six low-grade inflammation markers and four endothelial dysfunction markers respectively. Prevalent CVD was assessed with questionnaires, hospital records, ECG, and ABI. RESULTS Homozygous carriers (GG) had higher mean arterial pressure (103.8±12.4 mmHg vs 101.6±12.2 mmHg (mean±S.D.); P<0.05) compared with non-carriers (CC). Homozygous carriers had lower ABI compared with heterozygous carriers (CG) (1.08±0.13 vs 1.11±0.14; P<0.05). After adjustment for all covariates in the full model, the association with ABI was no longer significant. BclI was not associated with systolic blood pressure, cIMT, low-grade inflammation, endothelial dysfunction, and prevalent CVD. CONCLUSIONS The BclI polymorphism of the GR gene may contribute to an unfavorable cardiovascular profile; however, the effects on cardiovascular variables appear to be limited and partly mediated by the metabolic phenotype exerted by BclI.
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Affiliation(s)
- Dirk van Moorsel
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Marleen M J van Greevenbroek
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Nicolaas C Schaper
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Ronald M A Henry
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Charlotte C Geelen
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands
| | - Giel Nijpels
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands
| | - Leen M 't Hart
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Casper G Schalkwijk
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Carla J H van der Kallen
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Hans P Sauerwein
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Jacqueline M Dekker
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Bas Havekes
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
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Nomoto H, Miyoshi H, Furumoto T, Oba K, Tsutsui H, Miyoshi A, Kondo T, Tsuchida K, Atsumi T, Manda N, Kurihara Y, Aoki S. A Comparison of the Effects of the GLP-1 Analogue Liraglutide and Insulin Glargine on Endothelial Function and Metabolic Parameters: A Randomized, Controlled Trial Sapporo Athero-Incretin Study 2 (SAIS2). PLoS One 2015; 10:e0135854. [PMID: 26284918 PMCID: PMC4540491 DOI: 10.1371/journal.pone.0135854] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 07/26/2015] [Indexed: 02/06/2023] Open
Abstract
Objectives GLP-1 improves hyperglycemia, and it has been reported to have favorable effects on atherosclerosis. However, it has not been fully elucidated whether GLP-1 is able to improve endothelial function in patients with type 2 diabetes. Therefore, we investigated the efficacy of the GLP-1 analogue, liraglutide on endothelial function and glycemic metabolism compared with insulin glargine therapy. Materials and Methods In this multicenter, prospective randomized parallel-group comparison study, 31 diabetic outpatients (aged 60.3 ± 10.3 years with HbA1c levels of 8.6 ± 0.8%) with current metformin and/or sulfonylurea treatment were enrolled and randomly assigned to receive liraglutide or glargine therapy once daily for 14 weeks. Flow mediated dilation (FMD), a comprehensive panel of hemodynamic parameters (Task Force Monitor), and serum metabolic markers were assessed before and after the treatment period. Results A greater reduction (worsening) in %FMD was observed in the glargine group, although this change was not statistically different from the liraglutide group (liraglutide; 5.7 to 5.4%, glargine 6.7 to 5.7%). The augmentation index, C-peptide index, derivatives of reactive oxygen metabolites and BMI were significantly improved in the liraglutide group. Central systolic blood pressure and NT-proBNP also tended to be improved in the liraglutide-treated group, while improvements in HbA1c levels were similar between groups. Cardiac index, blood pressure and most other metabolic parameters were not different. Conclusions Regardless of glycemic improvement, early liraglutide therapy did not affect endothelial function but may provide favorable effects on beta-cell function and cardioprotection in type 2 diabetics without advanced atherosclerosis. Trial Registration UMIN Clinical Trials Registry System as trial ID UMIN000005331.
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Affiliation(s)
- Hiroshi Nomoto
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hideaki Miyoshi
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- * E-mail:
| | - Tomoo Furumoto
- Department of Cardiovascular Medicine, NTT East Japan Sapporo Hospital, Sapporo, Japan
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Koji Oba
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Arina Miyoshi
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takuma Kondo
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Tatsuya Atsumi
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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van Bussel FCG, van Bussel BCT, Hoeks APG, Op 't Roodt J, Henry RMA, Ferreira I, Vanmolkot FHM, Schalkwijk CG, Stehouwer CDA, Reesink KD. A control systems approach to quantify wall shear stress normalization by flow-mediated dilation in the brachial artery. PLoS One 2015; 10:e0115977. [PMID: 25693114 PMCID: PMC4333124 DOI: 10.1371/journal.pone.0115977] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 11/28/2014] [Indexed: 12/14/2022] Open
Abstract
Flow-mediated dilation is aimed at normalization of local wall shear stress under varying blood flow conditions. Blood flow velocity and vessel diameter are continuous and opposing influences that modulate wall shear stress. We derived an index FMDv to quantify wall shear stress normalization performance by flow-mediated dilation in the brachial artery. In 22 fasting presumed healthy men, we first assessed intra- and inter-session reproducibilities of two indices pFMDv and mFMDv, which consider the relative peak and relative mean hyperemic change in flow velocity, respectively. Second, utilizing oral glucose loading, we evaluated the tracking performance of both FMDv indices, in comparison with existing indices [i.e., the relative peak diameter increase (%FMD), the peak to baseline diameter ratio (Dpeak/Dbase), and the relative peak diameter increase normalized to the full area under the curve of blood flow velocity with hyperemia (FMD/shearAUC) or with area integrated to peak hyperemia (FMD/shearAUC_peak)]. Inter-session and intra-session reproducibilities for pFMDv, mFMDv and %FMD were comparable (intra-class correlation coefficients within 0.521-0.677 range). Both pFMDv and mFMDv showed more clearly a reduction after glucose loading (reduction of ~45%, p≤0.001) than the other indices (% given are relative reductions): %FMD (~11%, p≥0.074); Dpeak/Dbase (~11%, p≥0.074); FMD/shearAUC_peak (~20%, p≥0.016) and FMD/shearAUC (~38%, p≤0.038). Further analysis indicated that wall shear stress normalization under normal (fasting) conditions is already far from ideal (FMDv << 1), which (therefore) does not materially change with glucose loading. Our approach might be useful in intervention studies to detect intrinsic changes in shear stress normalization performance in conduit arteries.
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Affiliation(s)
- Frank C. G. van Bussel
- Department of Biomedical Engineering, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Radiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Bas C. T. van Bussel
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Arnold P. G. Hoeks
- Department of Biomedical Engineering, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Jos Op 't Roodt
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ronald M. A. Henry
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Isabel Ferreira
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Floris H. M. Vanmolkot
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Casper G. Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Coen D. A. Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Koen D. Reesink
- Department of Biomedical Engineering, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- * E-mail:
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Ito H, Nakashima M, Meguro K, Furukawa H, Yamashita H, Takaki A, Yukawa C, Omoto T, Shinozaki M, Nishio S, Abe M, Antoku S, Mifune M, Togane M. Flow Mediated Dilatation Is Reduced with the Progressive Stages of Glomerular Filtration Rate and Albuminuria in Type 2 Diabetic Patients without Coronary Heart Disease. J Diabetes Res 2015; 2015:728127. [PMID: 26064988 PMCID: PMC4429217 DOI: 10.1155/2015/728127] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 04/06/2015] [Accepted: 04/17/2015] [Indexed: 11/24/2022] Open
Abstract
We aimed to clarify the usefulness of measuring the flow mediated dilatation (FMD) in patients with type 2 diabetes mellitus without and with coronary heart disease (CHD). The FMD was measured in 480 patients with type 2 diabetes and in 240 nondiabetic subjects. The FMD was significantly lower in the subjects with CHD (n = 145, 5.4 ± 3.2%) than in those without CHD (n = 95, 6.9 ± 3.5%) among the nondiabetic subjects. The FMD was also lower in the subjects both with CHD (n = 161, 5.6 ± 2.8%) and without CHD (n = 319, 6.1 ± 3.3%) among the patients with diabetes compared to those without both diabetes and CHD. The FMD showed a significant positive correlation with the estimated glomerular filtration rate (eGFR) in the diabetic patients without CHD, while there was no significant association in those with CHD. The FMD was significantly lower with the progressive stages of the GFR or albuminuria in the patients without CHD among those with diabetes, although the FMD was not different in those with CHD. In conclusion, the FMD is considered to be useful for the detection of atherosclerosis in patients with type 2 diabetes, even if overt macroangiopathy is not diagnosed.
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Affiliation(s)
- Hiroyuki Ito
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
- *Hiroyuki Ito:
| | - Mina Nakashima
- Laboratory Department, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Kentaro Meguro
- Department of Cardiology, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Haruki Furukawa
- Laboratory Department, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Hitomi Yamashita
- Laboratory Department, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Akifusa Takaki
- Laboratory Department, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Chizuko Yukawa
- Laboratory Department, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Takashi Omoto
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Masahiro Shinozaki
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Shinya Nishio
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Mariko Abe
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Shinichi Antoku
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Mizuo Mifune
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
| | - Michiko Togane
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa, Tokyo 133-0052, Japan
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Madsen SM, Thorup AC, Overgaard K, Bjerre M, Jeppesen PB. Functional and structural vascular adaptations following 8 weeks of low volume high intensity interval training in lower leg of type 2 diabetes patients and individuals at high risk of metabolic syndrome. Arch Physiol Biochem 2015; 121:178-86. [PMID: 26471849 DOI: 10.3109/13813455.2015.1087033] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED We wished to investigate the effects of 8 weeks of low volume high intensity interval training (HIIT) on endothelial function of popliteal artery and circulating cell adhesion molecules in type 2 diabetes (T2D) patients and matched controls (CON). METHODS Over 8 weeks, non-active T2D patients and CONs cycled three times per week (10 × 60 sec HIIT). Pre- and post-HIIT measurements of endothelial function were conducted by applying flow-mediated dilation (FMD) along with taking venous blood samples. RESULTS Baseline diameter of popliteal artery increased significantly from an average of 5.53 mm to 5.97 mm (∼8%) in the CON-group (p = 0.006) and 5.32 mm to 5.61 mm (∼6%) in the T2D-group (p = 0.009). Peak diameter increased significantly from 5.82 mm to 6.36 mm (∼9%) in the CON-group (p = 0.001) and 5.57 mm to 5.93 mm (∼7%) in the T2D-group (p = 0.004). FMD% increased significantly from 5.12% to 6.58% in the CON-group (p = 0.004) and 4.84% to 5.66% in the T2D-group: (p = 0.045). The shear rate reduced significantly in both groups (CON-group: p = 0.04; T2D-group: p = 0.002). Circulating cell adhesion molecules remained unchanged (p > 0.05). CONCLUSION HIIT induced an improvement of endothelium-dependent FMD and significant outwards artery modelling. No changes in circulating cell adhesion molecules were observed.
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Affiliation(s)
- Søren Møller Madsen
- a Department of Endocrinology and Internal Medicine , Aarhus Sygehus THG, Aarhus University Hospital , Aarhus C , Denmark
| | - Anne Cathrine Thorup
- a Department of Endocrinology and Internal Medicine , Aarhus Sygehus THG, Aarhus University Hospital , Aarhus C , Denmark
| | - Kristian Overgaard
- b Section of Sport Science, Department of Public Health, Aarhus University , Aarhus , Denmark , and
| | - Mette Bjerre
- c The Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University , Denmark
| | - Per Bendix Jeppesen
- a Department of Endocrinology and Internal Medicine , Aarhus Sygehus THG, Aarhus University Hospital , Aarhus C , Denmark
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van Sloten TT, Henry RMA, Dekker JM, Nijpels G, Unger T, Schram MT, Stehouwer CDA. Endothelial Dysfunction Plays a Key Role in Increasing Cardiovascular Risk in Type 2 Diabetes. Hypertension 2014; 64:1299-305. [DOI: 10.1161/hypertensionaha.114.04221] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Thomas T. van Sloten
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Ronald M. A. Henry
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Jacqueline M. Dekker
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Giel Nijpels
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Thomas Unger
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Miranda T. Schram
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Coen D. A. Stehouwer
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
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Hornum M, Bay JT, Clausen P, Melchior Hansen J, Mathiesen ER, Feldt-Rasmussen B, Garred P. High levels of mannose-binding lectin are associated with lower pulse wave velocity in uraemic patients. BMC Nephrol 2014; 15:162. [PMID: 25281004 PMCID: PMC4197330 DOI: 10.1186/1471-2369-15-162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 09/25/2014] [Indexed: 11/23/2022] Open
Abstract
Background Uraemia is associated with a highly increased risk of cardiovascular disease. Mannose-binding lectin (MBL) has been shown to be involved in cardiovascular pathophysiology and a protective effect of MBL is suggested. The purpose of the present study was to evaluate a potential impact of MBL on vascular parameters in uraemic patients. Methods A cohort of 98 patients with end stage renal disease (ESRD) awaiting kidney transplantation had pulse wave velocity (PWV) and augmentation index (AIX) examined by tonometry and endothelial dependent flow-mediated (FMD) and endothelial independent nitroglycerin-induced (NID) dilatory capacities of the brachial artery measured by ultrasound. An oral glucose tolerance test (OGTT) was performed and serum levels of MBL were measured using Luminex xMAP bead array technology. Results The cohort was divided in two groups according to MBL-concentration below or above the median concentration. These groups were comparable regarding age, BMI, and duration of ESRD. PWV was significantly lower in the group with high MBL levels compared to the group with low MBL levels and trends toward better AIX and higher insulin sensitivity (ISI) was also seen in the group with high MBL levels. No difference was seen in FMD and NID. Conclusions High levels of MBL are associated with lower PWV and the use of antihypertensive drugs in a cohort of patients with ESRD awaiting kidney transplantation suggesting a beneficial role of high levels of MBL on arterial stiffness in uraemia.
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Affiliation(s)
- Mads Hornum
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Luttmer R, Spijkerman AM, Kok RM, Jakobs C, Blom HJ, Serne EH, Dekker JM, Smulders YM. Metabolic syndrome components are associated with DNA hypomethylation. Obes Res Clin Pract 2014; 7:e106-e115. [PMID: 24331772 DOI: 10.1016/j.orcp.2012.06.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 05/25/2012] [Accepted: 06/04/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND Disturbances of DNA methylation have been associated with multiple diseases, including cardiovascular disease, cancer and, as some have suggested, glucometabolic disturbances. Our aim was to assess the association of the metabolic syndrome and its individual components with DNA methylation in a population-based study. MATERIALS AND METHODS In a human population (n = 738) stratified by age, sex and glucose metabolism, we explored associations of the metabolic syndrome according to National Cholesterol Education Program/Adult Treatment Panel-III criteria and its individual components (fasting glucose, high-density lipoprotein cholesterol, triglycerides, blood pressure, waist circumference) with global leukocyte DNA methylation. DNA methylation was measured as the methylcytosine/cytosine ratio in peripheral leukocytes using liquid chromatography-tandem mass spectrometry. RESULTS Individuals with the metabolic syndrome had relative DNA hypomethylation compared to participants without the syndrome (β = -0.05; p = 0.01). This association was mainly attributable to linear associations of two metabolic syndrome components with DNA methylation: fasting plasma glucose (β = -0.02; p = 0.004) and high-density lipoprotein cholesterol (β = 0.07; p = 0.004). People with type 2 diabetes or impaired glucose metabolism had DNA hypomethylation compared to normoglycemic individuals (β = -0.05; p = 0.004). CONCLUSIONS DNA hypomethylation is independently associated with hyperglycemia and low high-density lipoprotein cholesterol, both essential components of the metabolic syndrome. The potential implications and direction of possible causality require further study.
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Affiliation(s)
- Roosmarijn Luttmer
- Faculty of Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Annemieke M Spijkerman
- Center for Prevention and Health Services Research, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Robert M Kok
- Department of Clinical Chemistry and Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands
| | - Carel Jakobs
- Department of Clinical Chemistry and Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands
| | - Henk J Blom
- Department of Clinical Chemistry and Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands
| | - Erik H Serne
- Department of Internal Medicine and Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, The Netherlands
| | - Jacqueline M Dekker
- Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Centre, Amsterdam, The Netherlands
| | - Yvo M Smulders
- Department of Internal Medicine and Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, The Netherlands.
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van Sloten TT, Schram MT, Adriaanse MC, Dekker JM, Nijpels G, Teerlink T, Scheffer PG, Pouwer F, Schalkwijk CG, Stehouwer CDA, Henry RMA. Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population: the Hoorn Study. Psychol Med 2014; 44:1403-1416. [PMID: 23942242 DOI: 10.1017/s0033291713002043] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Endothelial dysfunction (ED), low-grade inflammation (LGI) and oxidative stress (OxS) may be involved in the pathobiology of depression. Previous studies on the association of these processes in depression have yielded contradictory results. We therefore investigated comprehensively, in a population-based cohort study, the association between ED, LGI and OxS on the one hand and depressive symptoms on the other. METHOD We used data from the Hoorn Study and determined biomarkers of ED [flow-mediated dilatation (FMD), von Willebrand factor, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire (n = 493; age 68 years; 49.9% female). Regression analyses were performed with the use of biomarker Z scores. Adjustments were made for age, sex and glucose metabolism status (cohort stratification variables) and prior cardiovascular disease, hypertension, waist-to-hip ratio, cholesterol levels, education level, physical activity, dietary habits, and the use of antihypertensive and/or lipid-lowering medication and/or metformin (potential confounders). RESULTS After adjustment for age, sex and glucose metabolism status, one standard deviation increase in the ED Z score was associated with a 1.9 [95% confidence interval (CI) 0.7-3.1] higher CES-D score. Additional adjustments did not materially change this result. LGI and OxS were not associated with the CES-D score. CONCLUSIONS ED, as quantified by an array of circulating biomarkers and FMD, was independently associated with depressive symptoms. This study supports the hypothesis that ED plays an important role in the pathobiology of depression.
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Affiliation(s)
- T T van Sloten
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
| | - M T Schram
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
| | - M C Adriaanse
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - J M Dekker
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - G Nijpels
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - T Teerlink
- Metabolic Laboratory, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands
| | - P G Scheffer
- Metabolic Laboratory, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands
| | - F Pouwer
- Centre of Research on Psychology in Somatic Diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, The Netherlands
| | - C G Schalkwijk
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
| | - C D A Stehouwer
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
| | - R M A Henry
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
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Cassuto J, Dou H, Czikora I, Szabo A, Patel VS, Kamath V, Belin de Chantemele E, Feher A, Romero MJ, Bagi Z. Peroxynitrite disrupts endothelial caveolae leading to eNOS uncoupling and diminished flow-mediated dilation in coronary arterioles of diabetic patients. Diabetes 2014; 63:1381-93. [PMID: 24353182 PMCID: PMC3964507 DOI: 10.2337/db13-0577] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 12/10/2013] [Indexed: 12/18/2022]
Abstract
Peroxynitrite (ONOO(-)) contributes to coronary microvascular dysfunction in diabetes mellitus (DM). We hypothesized that in DM, ONOO(-) interferes with the function of coronary endothelial caveolae, which plays an important role in nitric oxide (NO)-dependent vasomotor regulation. Flow-mediated dilation (FMD) of coronary arterioles was investigated in DM (n = 41) and non-DM (n = 37) patients undergoing heart surgery. NO-mediated coronary FMD was significantly reduced in DM patients, which was restored by ONOO(-) scavenger, iron-(III)-tetrakis(N-methyl-4'pyridyl)porphyrin-pentachloride, or uric acid, whereas exogenous ONOO(-) reduced FMD in non-DM subjects. Immunoelectron microscopy demonstrated an increased 3-nitrotyrosine formation (ONOO(-)-specific protein nitration) in endothelial plasma membrane in DM, which colocalized with caveolin-1 (Cav-1), the key structural protein of caveolae. The membrane-localized Cav-1 was significantly reduced in DM and also in high glucose-exposed coronary endothelial cells. We also found that DM patients exhibited a decreased number of endothelial caveolae, whereas exogenous ONOO(-) reduced caveolae number. Correspondingly, pharmacological (methyl-β-cyclodextrin) or genetic disruption of caveolae (Cav-1 knockout mice) abolished coronary FMD, which was rescued by sepiapterin, the stable precursor of NO synthase (NOS) cofactor, tetrahydrobiopterin. Sepiapterin also restored coronary FMD in DM patients. Thus, we propose that ONOO(-) selectively targets and disrupts endothelial caveolae, which contributes to NOS uncoupling, and, hence, reduced NO-mediated coronary vasodilation in DM patients.
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Affiliation(s)
- James Cassuto
- Vascular Biology Center, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | - Huijuan Dou
- Vascular Biology Center, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | - Istvan Czikora
- Vascular Biology Center, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | - Andras Szabo
- Vascular Biology Center, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | - Vijay S. Patel
- Department of Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | - Vinayak Kamath
- Department of Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | | | - Attila Feher
- Vascular Biology Center, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | - Maritza J. Romero
- Vascular Biology Center, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | - Zsolt Bagi
- Vascular Biology Center, Medical College of Georgia, Georgia Regents University, Augusta, GA
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64
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Henriksen EJ. A radical concept on caveolae and endothelial dysfunction in coronary microvascular disease in diabetes. Diabetes 2014; 63:1200-2. [PMID: 24651806 DOI: 10.2337/db14-0057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Erik J Henriksen
- Department of Physiology, University of Arizona College of Medicine, Tucson, AZ
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65
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A short-term incubation with high glucose impairs VASP phosphorylation at serine 239 in response to the nitric oxide/cGMP pathway in vascular smooth muscle cells: role of oxidative stress. BIOMED RESEARCH INTERNATIONAL 2014; 2014:328959. [PMID: 24779009 PMCID: PMC3981118 DOI: 10.1155/2014/328959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/31/2014] [Accepted: 02/15/2014] [Indexed: 11/29/2022]
Abstract
A reduction of the nitric oxide (NO) action in vascular smooth muscle cells (VSMC) could play a role in the vascular damage induced by the glycaemic excursions occurring in diabetic patients; in this study, we aimed to clarify whether a short-term incubation of cultured VSMC with high glucose reduces the NO ability to increase cGMP and the cGMP ability to phosphorylate VASP at Ser-239. We observed that a 180 min incubation of rat VSMC with 25 mmol/L glucose does not impair the NO-induced cGMP increase but reduces VASP phosphorylation in response to both NO and cGMP with a mechanism blunted by antioxidants. We further demonstrated that high glucose increases radical oxygen species (ROS) production and that this phenomenon is prevented by the PKC inhibitor chelerythrine and the NADPH oxidase inhibitor apocynin. The following sequence of events is supported by these results: (i) in VSMC high glucose activates PKC; (ii) PKC activates NADPH oxidase; (iii) NADPH oxidase induces oxidative stress; (iv) ROS impair the signalling of cGMP, which is involved in the antiatherogenic actions of NO. Thus, high glucose, via oxidative stress, can reduce the cardiovascular protection conferred by the NO/cGMP pathway via phosphorylation of the cytoskeleton protein VASP in VSMC.
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66
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Higher central fat mass and lower peripheral lean mass are independent determinants of endothelial dysfunction in the elderly: The Hoorn study. Atherosclerosis 2014; 233:310-8. [DOI: 10.1016/j.atherosclerosis.2013.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 11/14/2013] [Accepted: 12/13/2013] [Indexed: 02/04/2023]
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67
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Kinouchi M, Aihara KI, Fujinaka Y, Yoshida S, Ooguro Y, Kurahashi K, Kondo T, Aki N, Kuroda A, Endo I, Matsuhisa M, Matsumoto T. Diabetic Conditions Differentially Affect the Endothelial Function, Arterial Stiffness and Carotid Atherosclerosis. J Atheroscler Thromb 2014; 21:486-500. [DOI: 10.5551/jat.20834] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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68
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Shan Y, Lin J, Xu P, Zeng M, Lin H, Yan H. The combined effect of hypertension and type 2 diabetes mellitus on aortic stiffness and endothelial dysfunction: an integrated study with high-resolution MRI. Magn Reson Imaging 2013; 32:211-6. [PMID: 24462301 DOI: 10.1016/j.mri.2013.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 10/26/2013] [Accepted: 12/23/2013] [Indexed: 02/08/2023]
Abstract
PURPOSE The purpose of this study was to investigate the combined effect of hypertension and type 2 diabetes mellitus (DM2) on aortic stiffness and endothelial dysfunction by using an integrated MRI approach. MATERIALS AND METHODS A total of 31 non-hypertensive DM2 patients and 31 hypertensive DM2 patients underwent 3.0-T MRI. Aortic distensibility (AD), pulse wave velocity (PWV) and brachial artery flow-mediated dilation (FMD) were assessed. Student's t-test, Mann-Whitney U test, chi-squared test, Pearson correlation analysis, and univariable and multiple linear regression analyses were used for statistical analyses. RESULTS The hypertensive patients showed lower AD at multiple levels (ascending aorta [AA]: 2.07±0.98×10(-3)mm Hg(-1) vs. 3.21±1.70×10(-3)mm Hg(-1), p<0.01; proximal thoracic descending aorta [PDA]: 2.58±0.72×10(-3)mm Hg(-1) vs. 3.58±1.47×10(-3)mm Hg(-1), p<0.01; distal descending aorta [DDA]: 3.11±1.84×10(-3)mm Hg(-1) vs. 4.27±1.75×10(-3)mm Hg(-1), p<0.01); faster PWV (7.46±2.28m/s vs. 5.82±1.12m/s, p<0.05) and lower FMD (12.67%±6.49% vs. 20.66%±9.7%; p<0.01). Systolic blood pressure was an independent predictor of PWV, AA-AD, DDA-AD and FMD. FMD was statistically significantly associated with PWV (r=-0.37, p<0.01) and AD (p<0.01). CONCLUSIONS Hypertension has a contributive effect on aortic stiffness and endothelial dysfunction in DM2 patients.
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Affiliation(s)
- Yan Shan
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Jiang Lin
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China.
| | - Pengju Xu
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Huandong Lin
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Hongmei Yan
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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69
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Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study. PLoS One 2013; 8:e84603. [PMID: 24386401 PMCID: PMC3873439 DOI: 10.1371/journal.pone.0084603] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 11/16/2013] [Indexed: 01/22/2023] Open
Abstract
A large body of evidence underlines an association between periodontal disease and cardiovascular disease. In contrast, data on its relation with endothelial dysfunction as a marker of early subclinical atherosclerosis is inconclusive and limited to patient-cohort studies. We therefore investigated the association between periodontal disease and flow-mediated dilation of the brachial artery (FMD) as a measure of endothelial dysfunction in a general population, and also addressed a possible mediation via inflammation. The study population comprised 1,234 subjects (50.5% men) aged 25–85 years from the 5-year follow-up of the Study of Health in Pomerania, a population-based cohort study. Clinical attachment loss (CAL) and pocket probing depth (PPD) as measures of periodontal disease were assessed half-mouth at four sites per tooth. Subjects were classified according to the periodontitis case definition proposed by Tonetti and Claffey (2005). Measurements of FMD and nitroglycerin-mediated dilation (NMD) were performed using standardized ultrasound techniques. High-sensitive C-reactive protein, fibrinogen and leukocyte count were measured. Fully adjusted multivariate linear regression analyses revealed significant associations of the percentage of sites with PPD ≥6 mm with FMD (ptrend=0.048), with subjects within the highest category having a 0.74% higher FMD compared to subjects within the lowest category (p<0.05). Consistently, FMD values increased significantly across categories of the percentage of sites with CAL ≥6 mm (ptrend=0.01) and the periodontitis case definition (ptrend=0.006). Restrictions to subjects without antihypertensive or statin medication or current non-smokers confirmed previous results. Systemic inflammation did not seem to mediate the relation. Both PPD and CAL were not consistently associated with NMD. In contrast to previous studies, high levels of periodontal disease were significantly associated with high FMD values. This association was not mediated via systemic inflammation. This study revives the discussion on whether and how periodontitis contributes to endothelial dysfunction.
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70
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Empen K, Lorbeer R, Völzke H, Reffelmann T, Schipf S, Nauck M, Kerner W, Wallaschofski H, Felix SB, Dörr M. Do patients with type 1 and type 2 diabetes really have an impaired endothelial function? A population-based propensity score matching analysis. Cardiovasc Diabetol 2013; 12:174. [PMID: 24305508 PMCID: PMC4234402 DOI: 10.1186/1475-2840-12-174] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/02/2013] [Indexed: 01/22/2023] Open
Abstract
Background Previous studies suggested an impaired endothelial function in patients with diabetes. However, the validity of this finding may be limited by the lack of adequate adjustment for further cardiovascular confounders. We assessed endothelial function as measured by flow-mediated dilation (FMD) of the brachial artery in patients with either type 1 or type 2 diabetes in comparison with non-diabetic controls. Methods The study population comprised 1487 subjects including 122 subjects with type 2 diabetes, aged 25 to 85, from the population-based Study of Health in Pomerania, and 65 outpatients, aged 23 to 75, with type 1 diabetes. FMD measurements were performed using standardized ultrasound techniques. Subjects with type 1 and type 2 diabetes were matched 1:4 to healthy controls using propensity score matching. Results Neither type 1 diabetes (β = 0.142; SE = 0.568, p = 0.803) nor type 2 diabetes (β = 0.107; SE = 0.340, p = 0.752) were significantly associated with FMD in comparison with their non-diabetic controls after adjustment for major cardiovascular confounders like age, gender, body mass index, smoking status, hypertension, antihypertensive medication, LDL and HDL cholesterol levels. Conclusions In this population-based study comparing adjusted FMD values of diabetic individuals with adequately matched controls, propensity score analyses revealed no association between diabetes and endothelial function. Since these findings are in discordance with the majority of previous reports, we suggest performing similar analyses using data from other population-based studies.
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Affiliation(s)
- Klaus Empen
- Department of Internal Medicine, Medizinische Klinik B, Universitätsmedizin, Greifswald, Sauerbruchstrasse, D-17475, Germany.
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71
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Ashraf H, Boroumand MA, Amirzadegan A, Talesh SA, Davoodi G. Hemoglobin A1C in non-diabetic patients: an independent predictor of coronary artery disease and its severity. Diabetes Res Clin Pract 2013; 102:225-32. [PMID: 24176244 DOI: 10.1016/j.diabres.2013.10.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 07/27/2013] [Accepted: 10/02/2013] [Indexed: 12/14/2022]
Abstract
AIMS To determine the association between glycated hemoglobin (HbA1c) and angiographically proven coronary artery disease (CAD) and its severity in nondiabetic individuals. METHODS We enrolled 299 consecutive individuals undergoing coronary angiography for suspected ischemia. Patients were included if they had no history of prior revascularization or diabetes mellitus and had fasting blood glucose<126mg/dl (7.0mmol/l) and HbA1c<6.5% (47mmol/mol). The severity of the CAD was also evaluated using the Gensini score. Serum HbA1c (NGSP certified Method), highly sensitive C-reactive protein (hsCRP), lipid profile, insulin and APO lipoprotein A1 and B100 levels were measured. RESULTS Mean age was 58.8±10.4 year; 60.9% men. One hundred forty seven patients had significant CAD (≥50% stenosis in any major vessel). With increasing HbA1c levels, there was a significant increase in the prevalence of CAD and number of vessels involved. In multivariate analysis, HbA1c emerged as an independent predictor of significant CAD (OR: 2.8, 95% CI: 1.3-6.2, p=0.009). Adjusted ORs for the occurrence of CAD were highest in subjects with both hsCRP and HbA1c in the upper 2 quartiles (OR: 4.183; 95% CI: 1.883-9.290, p<0.0001). There was a significant association between Gensini score and increasing HbA1c tertiles (p=0.038). The ideal cut-off value of HbA1c for prediction of the occurrence of CAD was 5.6% 38mmol/mol) (sensitivity: 60.5%, specificity: 52%). CONCLUSIONS In non-diabetic subjects, HbA1c could be utilized for risk stratification of CAD and its severity, independent of traditional cardiovascular risk factors, insulin resistance and inflammatory markers.
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Affiliation(s)
- Haleh Ashraf
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Street, Tehran, Iran
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72
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Hamilton SJ, Watts GF. Endothelial dysfunction in diabetes: pathogenesis, significance, and treatment. Rev Diabet Stud 2013; 10:133-56. [PMID: 24380089 DOI: 10.1900/rds.2013.10.133] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Type 2 diabetes (T2D) markedly increases the risk of cardiovascular disease. Endothelial dysfunction (ED), an early indicator of diabetic vascular disease, is common in T2D and independently predicts cardiovascular risk. Although the precise pathogenic mechanisms for ED in T2D remain unclear, at inception they probably involve uncoupling of both endothelial nitric oxide synthase activity and mitochondrial oxidative phosphorylation, as well as the activation of vascular nicotinamide adenine dinucleotide phosphate oxidase. The major contributing factors include dyslipoproteinemia, oxidative stress, and inflammation. Therapeutic interventions are designed to target these pathophysiological factors that underlie ED. Therapeutic interventions, including lifestyle changes, antiglycemic agents and lipid-regulating therapies, aim to correct hyperglycemia and atherogenic dyslipidemia and to improve ED. However, high residual cardiovascular risk is seen in both research and clinical practice settings. Well-designed studies of endothelial function in appropriately selected volunteers afford a good opportunity to test new therapeutic interventions, paving the way for clinical trials and utilization in the care of the diabetic patient. However, based on the results from a recent clinical trial, niacin should not be added to a statin in individuals with low high-density lipoprotein cholesterol and very well controlled low-density lipoprotein cholesterol.
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Affiliation(s)
- Sandra J Hamilton
- Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - Gerald F Watts
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Australia
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73
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Yun JS, Ko SH, Kim JH, Moon KW, Park YM, Yoo KD, Ahn YB. Diabetic retinopathy and endothelial dysfunction in patients with type 2 diabetes mellitus. Diabetes Metab J 2013; 37:262-9. [PMID: 23991404 PMCID: PMC3753491 DOI: 10.4093/dmj.2013.37.4.262] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/19/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We investigated the relationship between endothelial dysfunction and diabetic retinopathy (DR) in patients with type 2 diabetes. METHODS We used a cross-sectional design to examine 167 patients with type 2 diabetes mellitus. All patients underwent biochemical and ophthalmological examination. We assessed endothelial dysfunction by a flow-mediated vasodilation method of the brachial artery. Changes in vasodilation (flow-mediated vasodilatation, %FMD) were expressed as percent change over baseline values. RESULTS The mean±standard deviation of patient age was 54.1±8.6 years. The %FMD was significantly lower in patients with DR than without DR. The prevalence of retinopathy decreased across increasing tertiles of %FMD. After adjusting for patients' age, sex, diabetes duration, use of insulin, use of antihypertensive, antiplatelet, and lipid lowering medications, systolic blood pressure, fasting plasma glucose, 2-hour plasma glucose, glycated hemoglobin, and urinary albumin excretion, participants with a reduced %FMD were more likely to have DR (odds ratio, 11.819; 95% confidence interval, 2.201 to 63.461; P=0.004, comparing the lowest and highest tertiles of %FMD). CONCLUSION Endothelial dysfunction was associated with DR, which was most apparent when the endothelial dysfunction was severe. Our study provides insights into the possible mechanism of the influence of endothelial dysfunction on the development of DR.
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Affiliation(s)
- Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Ji-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Kun-Woong Moon
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Yong-Moon Park
- Department of Preventive Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
- Department of Epidemiology and Biostatistics, Arnold School of Public health, University of South Carolina, Columbia, SC, USA
| | - Ki-Dong Yoo
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
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74
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Wong RH, Coates AM, Buckley JD, Howe PR. Evidence for circulatory benefits of resveratrol in humans. Ann N Y Acad Sci 2013; 1290:52-8. [DOI: 10.1111/nyas.12155] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Rachel H.X. Wong
- Nutritional Physiology Research Centre; Sansom Institute for Health Research; University of South Australia; Adelaide Australia
| | - Alison M. Coates
- Nutritional Physiology Research Centre; Sansom Institute for Health Research; University of South Australia; Adelaide Australia
| | - Jonathan D. Buckley
- Nutritional Physiology Research Centre; Sansom Institute for Health Research; University of South Australia; Adelaide Australia
| | - Peter R.C. Howe
- Nutritional Physiology Research Centre; Sansom Institute for Health Research; University of South Australia; Adelaide Australia
- Clinical Nutrition Research Centre; University of Newcastle; Callaghan New South Wales Australia
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75
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Gilchrist M, Winyard PG, Aizawa K, Anning C, Shore A, Benjamin N. Effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes. Free Radic Biol Med 2013; 60:89-97. [PMID: 23395779 DOI: 10.1016/j.freeradbiomed.2013.01.024] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/17/2013] [Accepted: 01/22/2013] [Indexed: 11/15/2022]
Abstract
Diets rich in green, leafy vegetables have been shown to lower blood pressure (BP) and reduce the risk of cardiovascular disease. Green, leafy vegetables and beetroot are particularly rich in inorganic nitrate. Dietary nitrate supplementation, via sequential reduction to nitrite and NO, has previously been shown to lower BP and improve endothelial function in healthy humans. We sought to determine if supplementing dietary nitrate with beetroot juice, a rich source of nitrate, will lower BP and improve endothelial function and insulin sensitivity in individuals with type 2 diabetes (T2DM). Twenty-seven patients, age 67.2±4.9 years (18 male), were recruited for a double-blind, randomized, placebo-controlled crossover trial. Participants were randomized to begin, in either order, a 2-week period of supplementation with 250ml beetroot juice daily (active) or 250ml nitrate-depleted beetroot juice (placebo). At the conclusion of each intervention period 24-h ambulatory blood pressure monitoring, tests of macro- and microvascular endothelial function, and a hyperinsulinemic isoglycemic clamp were performed. After 2 weeks administration of beetroot juice mean ambulatory systolic BP was unchanged: 134.6±8.4mmHg versus 135.1±7.8mmHg (mean±SD), placebo vs active-mean difference of -0.5mmHg (placebo-active), p=0.737 (95% CI -3.9 to 2.8). There were no changes in macrovascular or microvascular endothelial function or insulin sensitivity. Supplementation of the diet with 7.5mmol of nitrate per day for 2 weeks caused an increase in plasma nitrite and nitrate concentration, but did not lower BP, improve endothelial function, or improve insulin sensitivity in individuals with T2DM.
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Affiliation(s)
- Mark Gilchrist
- NIHR Exeter Clinical Research Facility and Institute of Biomedical and Clinical Science, University of Exeter Medical School (previously Peninsula College of Medicine and Dentistry), University of Exeter, Exeter EX2 5AX, UK.
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76
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Lee JO, Auger C, Park DH, Kang M, Oak MH, Kim KR, Schini-Kerth VB. An ethanolic extract of Lindera obtusiloba stems, YJP-14, improves endothelial dysfunction, metabolic parameters and physical performance in diabetic db/db mice. PLoS One 2013; 8:e65227. [PMID: 23755196 PMCID: PMC3670856 DOI: 10.1371/journal.pone.0065227] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 04/24/2013] [Indexed: 01/08/2023] Open
Abstract
Lindera obtusiloba is a medicinal herb traditionally used in Asia for improvement of blood circulation, treatment of inflammation, and prevention of liver damage. A previous study has shown that an ethanolic extract of Lindera obtusiloba stems (LOE) has vasoprotective and antihypertensive effects. The possibility that Lindera obtusiloba improves endothelial function and metabolic parameters in type 2 diabetes mellitus (T2DM) remains to be examined. Therefore, the aim of the present study was to determine the potential of LOE to prevent the development of an endothelial dysfunction, and improve metabolic parameters including hyperglycemia, albuminuria and physical exercise capacity in db/db mice, an experimental model of T2DM. The effect of LOE (100 mg/kg/day by gavage for 8 weeks) on these parameters was compared to that of an oral antidiabetic drug, pioglitazone (30 mg/kg/day by gavage). Reduced blood glucose level, body weight and albumin-creatinine ratio were observed in the group receiving LOE compared to the control db/db group. The LOE treatment improved endothelium-dependent relaxations, abolished endothelium-dependent contractions to acetylcholine in the aorta, and normalized the increased vascular oxidative stress and expression of NADPH oxidase, cyclooxygenases, angiotensin II, angiotensin type 1 receptors and peroxynitrite and the decreased expression of endothelial NO synthase in db/db mice. The angiotensin-converting enzyme (ACE) activity was reduced in the LOE group compared to that in the control db/db group. LOE also inhibited the activity of purified ACE, COX-1 and COX-2 in a dose-dependent manner. In addition, LOE improved physical exercise capacity. Thus, the present findings indicate that LOE has a beneficial effect on the vascular system in db/db mice by improving endothelium-dependent relaxations and vascular oxidative stress most likely by normalizing the angiotensin system, and also on metabolic parameters, and these effects are associated with an enhanced physical exercise capacity.
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MESH Headings
- Albuminuria/prevention & control
- Angiotensin II/genetics
- Angiotensin II/metabolism
- Animals
- Aorta/drug effects
- Aorta/physiopathology
- Blood Glucose/metabolism
- Body Weight/drug effects
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/physiopathology
- Disease Models, Animal
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/metabolism
- Ethanol/chemistry
- Exercise Tolerance/drug effects
- Gene Expression/drug effects
- Humans
- Hyperglycemia/prevention & control
- Hypoglycemic Agents/pharmacology
- Lindera/chemistry
- Male
- Mice
- Mice, Transgenic
- NADPH Oxidases/genetics
- NADPH Oxidases/metabolism
- Nitric Oxide Synthase Type III/genetics
- Nitric Oxide Synthase Type III/metabolism
- Pioglitazone
- Plant Extracts/pharmacology
- Prostaglandin-Endoperoxide Synthases/genetics
- Prostaglandin-Endoperoxide Synthases/metabolism
- Receptor, Angiotensin, Type 1/genetics
- Receptor, Angiotensin, Type 1/metabolism
- Thiazolidinediones/pharmacology
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Affiliation(s)
- Jung-Ok Lee
- UMR CNRS 7213, Laboratoire de Biophotonique et Pharmacologie, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
- Research and Development Center, Hanwha Pharma. Co., Ltd., Chuncheon, Republic of Korea
| | - Cyril Auger
- UMR CNRS 7213, Laboratoire de Biophotonique et Pharmacologie, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Dong Hyun Park
- Research Center, YangJi Chemicals, Suwon, Republic of Korea
| | - Moonkyu Kang
- Research and Development Center, Hanwha Pharma. Co., Ltd., Chuncheon, Republic of Korea
| | - Min-Ho Oak
- College of Pharmacy, Mokpo National University, Muan, Jeonam, Republic of Korea
| | - Kyoung Rak Kim
- Research and Development Center, Hanwha Pharma. Co., Ltd., Chuncheon, Republic of Korea
| | - Valérie B. Schini-Kerth
- UMR CNRS 7213, Laboratoire de Biophotonique et Pharmacologie, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
- * E-mail:
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77
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Kanaya AM, Dobrosielski DA, Ganz P, Creasman J, Gupta R, Nelacanti V, Vogel-Claussen J, Herrington D. Glycemic associations with endothelial function and biomarkers among 5 ethnic groups: the Multi-Ethnic Study of Atherosclerosis and the Mediators of Atherosclerosis in South Asians Living in America studies. J Am Heart Assoc 2013; 2:e004283. [PMID: 23525433 PMCID: PMC3603246 DOI: 10.1161/jaha.112.004283] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background The association of prediabetic states with endothelial dysfunction measured by flow‐mediated dilation (FMD) or endothelial biomarker levels remains controversial. We examined data from 5 ethnic groups to determine the association between glucose categories and FMD or endothelial biomarkers. We determined whether these associations vary by ethnic group or body mass index. Methods and Results We used data from 3516 participants from 5 race/ethnic groups with brachial FMD, endothelial biomarkers, and glucose category (normal, impaired fasting glucose [IFG], and diabetes) measures. There were significant ethnic differences in FMD, biomarker levels, and the prevalence of IFG and diabetes. However, all 5 ethnic groups showed similar patterns of higher FMD for the IFG group compared with the normal glucose and diabetes groups, which was most significant among whites and Asian Indians. Associations between glucose categories and endothelial biomarkers were more uniform, with the IFG and diabetes groups having higher biomarker levels than the normal glucose group. These associations did not change with further adjustment for fasting insulin levels. Whites with normal BMI had higher FMD values with higher glucose levels, but those with BMI in the overweight or obese categories had the inverse association (P for interaction=0.01). Conclusions The discordance of IFG being associated with higher FMD but more abnormal endothelial biomarker levels is a novel finding. This higher FMD for the IFG group was most notable in whites of normal BMI. The higher FMD among those with impaired fasting glucose may reflect differences in insulin signaling pathways between the endothelium and skeletal muscle.
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Affiliation(s)
- Alka M Kanaya
- University of California, San Francisco, CA 94143-0320, USA.
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78
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Naka KK, Papathanassiou K, Bechlioulis A, Kazakos N, Pappas K, Tigas S, Makriyiannis D, Tsatsoulis A, Michalis LK. Determinants of vascular function in patients with type 2 diabetes. Cardiovasc Diabetol 2012; 11:127. [PMID: 23062182 PMCID: PMC3490819 DOI: 10.1186/1475-2840-11-127] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 09/06/2012] [Indexed: 02/06/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is independently associated with an increased risk for cardiovascular diseases that is primarily due to the early development of advanced atherosclerotic vascular changes. The aim of our study was to investigate the predictors of vascular dysfunction in T2DM patients. Methods We studied 165 T2DM patients without known macrovascular or microvascular disease. Standard demographic (age, gender, cardiovascular risk factors, medications), clinical (body mass index, blood pressure) and laboratory (glucose, glycated hemoglobin, lipids, renal function) parameters were included in analyses. Brachial artery flow-mediated dilation (FMD), nitrate mediated dilation (NMD) and Carotid-Femoral Pulse Wave Velocity (PWV) were measured. Results Median age was 66 years and duration since T2DM diagnosis was 10 years, 70% were females and 79% hypertensives, while only 10% had a glycated hemoglobin <7%. FMD was positively associated with NMD (r 0.391, P < 0.001), while PWV was inversely associated with FMD (r -0.218, P = 0.014) and NMD (r -0.309, P < 0.001). Time since diagnosis of diabetes was the single independent predictor of FMD (β -0.40, P = 0.003). Increased age and fasting glucose and the presence of hypertension were independent predictors of decreased NMD (P < 0.001). Increased age and systolic blood pressure were independently associated with increased PWV (P < 0.001). Conclusions In T2DM patients, impairment of endothelium-dependent vasodilation was independently associated only with longer diabetes duration while no association with other established risk factors was found. Vascular smooth muscle dysfunction and increased arterial stiffness were more prominent in older T2DM patients with hypertension. Worse glycemic control was associated with impaired vascular smooth muscle function.
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Affiliation(s)
- Katerina K Naka
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece
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79
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Cherney DZI, Reich HN, Jiang S, Har R, Nasrallah R, Hébert RL, Lai V, Scholey JW, Sochett EB. Hyperfiltration and effect of nitric oxide inhibition on renal and endothelial function in humans with uncomplicated type 1 diabetes mellitus. Am J Physiol Regul Integr Comp Physiol 2012; 303:R710-8. [PMID: 22855276 DOI: 10.1152/ajpregu.00286.2012] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Studies of experimental diabetes mellitus (DM) suggest that increased nitric oxide (NO) bioactivity contributes to renal hyperfiltration. However, the role of NO in mediating hyperfiltration has not been fully elucidated in humans. Our aim was to examine the effect of NO synthase inhibition on renal and peripheral vascular function in normotensive subjects with uncomplicated type 1 DM. Renal function and brachial artery flow-mediated vasodilatation (FMD) were measured before and after an intravenous infusion of the NO synthase inhibitor N(G)-nitro-l-arginine methyl ester (l-NMMA) in 21 healthy control and 37 type 1 DM patients. Measurements in DM participants were made under clamped euglycemic conditions. The effect of l-NMMA on circulating and urinary NO metabolites (NO(x)) and cGMP and on urinary prostanoids was also determined. Baseline characteristics were similar in the two groups. For analysis, the DM patients were divided into those with hyperfiltration (DM-H, n = 18) and normal glomerular filtration rate (GFR) levels (DM-N, n = 19). Baseline urine NO(x) and cGMP were highest in DM-H. l-NMMA led to a decline in GFR in DM-H (152 ± 16 to 140 ± 11 ml·min(-1)·1.73 m(-2)) but not DM-N or healthy control participants. The decline in effective renal plasma flow in response to l-NMMA (806 ± 112 to 539 ± 80 ml·min(-1)·1.73 m(-2)) in DM-H was also exaggerated compared with the other groups (repeated measures ANOVA, P < 0.05), along with declines in urinary NO(x) metabolites and cGMP. Baseline FMD was lowest in DM-H compared with the other groups and did not change in response to l-NMMA. l-NMMA reduced FMD and plasma markers of NO bioactivity in the healthy control and DM-N groups. In patients with uncomplicated type 1 DM, renal hyperfiltration is associated with increased NO bioactivity in the kidney and reduced NO bioactivity in the systemic circulation, suggesting a paradoxical state of high renal and low systemic vascular NO bioactivity.
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80
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Sogawa K, Nagaoka T, Tanano I, Tani T, Omae T, Nakabayashi S, Ishibazawa A, Takahashi A, Yoshida A. Association between diabetic retinopathy and flow-mediated vasodilation in type 2 DM. Curr Eye Res 2012; 37:446-51. [PMID: 22510012 DOI: 10.3109/02713683.2012.654883] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Retinal endothelial dysfunction is a key in the etiogenesis of diabetic retinopathy (DR), in patients with type 2 diabetes mellitus (DM). Brachial artery flow-mediated vasodilation (FMD) is a marker of endothelial function associated with production of endogenous nitric oxide. Using FMD, we investigated the relationship between macrovascular function and DR. METHODS We studied 74 patients with type 2 DM, including non-DR (NDR) (n = 30); mild nonproliferative DR (NPDR) (n = 16); moderate NPDR (n = 10); severe NPDR (n = 10); and proliferative DR (PDR) (n = 8); and 21 age-matched controls. We measured FMD in each group. Retinal blood flow and pulsatility ratios were measured using laser Doppler velocimetry. RESULTS FMD decreased significantly in patients with DM compared with healthy control subjects. No significant differences were found in FMD among the NDR, mild NPDR, and moderate NPDR groups. FMD decreased significantly in the severe NPDR and PDR groups compared with the NDR group. FMD was significantly and negatively correlated with duration of DM and pulsatility ratio. CONCLUSION Systemic endothelial dysfunction appears to be associated with DR and vascular abnormalities in patients with type 2 DM.
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Affiliation(s)
- Kenji Sogawa
- Department of Ophthalmology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan.
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81
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Low-grade inflammation, but not endothelial dysfunction, is associated with greater carotid stiffness in the elderly: the Hoorn Study. J Hypertens 2012; 30:744-52. [PMID: 22343535 DOI: 10.1097/hjh.0b013e328350a487] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Biomarkers of low-grade inflammation and endothelial dysfunction are associated with cardiovascular disease. Arterial stiffening may be a mechanism through which low-grade inflammation and (or) endothelial dysfunction lead to cardiovascular disease. Therefore, we investigated whether low-grade inflammation and endothelial dysfunction were associated with greater carotid stiffness in a population-based cohort of elderly individuals. METHODS We determined biomarkers of low-grade inflammation (C-reactive protein, serum amyloid A, interleukin 6, interleukin 8, tumour necrosis factor α and soluble intercellular adhesion molecule 1), and of endothelial dysfunction (von Willebrand factor, soluble vascular cell adhesion molecule 1, soluble endothelial selectin, soluble thrombomodulin, soluble intercellular adhesion molecule 1 and flow-mediated dilation), and combined these into mean z-scores (n = 572; women = 286; age 67.5 ± 6.6 years). Additionally, we determined by ultrasonography carotid diameter, distension, pulse pressure and intima-media thickness. Carotid stiffness indices were determined by calculation of the distensibility and compliance coefficient, Young's elastic modulus and β stiffness index. RESULTS The study population was characterized by a high prevalence of cardiovascular disease (46%), hypertension (66%) and the use of lipid-lowering (16%) and antihypertensive (34%) medication. After adjustment for the above in addition to sex, age, glucose tolerance status and current smoking, the low-grade inflammation z-score was positively associated with Young's elastic modulus [β (95% confidence interval) 0.080 (0.021-0.139), P = 0.008]. This association was primarily driven through greater diameter. After adjustment for the variables above, the endothelial dysfunction z-score was not associated with carotid stiffness. CONCLUSION These data suggest that low-grade inflammation, in the elderly, plays an important role in carotid artery remodelling and stiffening.
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82
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Heringa SM, van den Berg E, Dekker JM, Nijpels G, Kessels RPC, Kappelle LJ, Stehouwer CDA, Biessels GJ. Albuminuria and cognitive functioning in an older population: the Hoorn study. Dement Geriatr Cogn Disord 2012; 32:182-7. [PMID: 22024942 DOI: 10.1159/000333076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Markers of vascular disease elsewhere in the body may reflect vascular abnormalities in the brain relevant to age-related cognitive decline and dementia. We examined the association between albuminuria, as a marker of microvascular damage, and cognition in older individuals. METHODS 380 individuals (age 73 ± 6 years), participating in the population-based Hoorn Study, underwent extensive neuropsychological examination in 2005-2008, and urinary albumin-to-creatinine ratios measurements in 2000-2001 (n = 378) and/or 2005-2008 (n = 346). Cognition was expressed in z-scores on 6 domains. RESULTS In 2000-2001, 42 participants were with and 336 without albuminuria, and in 2005-2008 51 were with and 295 were without. In age-, sex- and premorbid IQ-adjusted analyses, participants with albuminuria 5-7 years earlier had slightly lower z-scores for the domains attention and executive functioning [mean difference: -0.21 (95% CI -0.40 to -0.02)] and language [-0.36 (95% CI -0.63 to -0.09)]. No statistically significant differences in cognition were found between participants with and without albuminuria at the time of neuropsychological testing. CONCLUSION Albuminuria predicts future modest cognitive decrements, but concurrent albuminuria is unrelated to cognitive functioning. The link between albuminuria and cognitive dysfunction may convey an etiological message, but because effect sizes were modest its value in prognostic models for cognitive decline may be limited.
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Affiliation(s)
- S M Heringa
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands. s.m.heringa @ umcutrecht.nl
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83
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Seon CS, Min KW, Lee SY, Nho KW, Park SH, Koo BK, Han KA. Cardiovascular Risk Assessment with Vascular Function, Carotid Atherosclerosis and the UKPDS Risk Engine in Korean Patients with Newly Diagnosed Type 2 Diabetes. Diabetes Metab J 2011; 35:619-27. [PMID: 22247905 PMCID: PMC3253973 DOI: 10.4093/dmj.2011.35.6.619] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 07/26/2011] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Patients with type 2 diabetes have an increased risk of cardiovascular disease. Few studies have evaluated the cardiovascular disease (CVD) risk simultaneously using the United Kingdom Prospective Diabetes Study (UKPDS) risk engine and non-invasive vascular tests in patients with newly diagnosed type 2 diabetes. METHODS Participants (n=380; aged 20 to 81 years) with newly diagnosed type 2 diabetes were free of clinical evidence of CVD. The 10-year coronary heart disease (CHD) and stroke risks were calculated for each patient using the UKPDS risk engine. Carotid intima media thickness (CIMT), flow mediated dilation (FMD), pulse wave velocity (PWV) and augmentation index (AI) were measured. The correlations between the UKPDS risk engine and the non-invasive vascular tests were assessed using partial correlation analysis, after adjusting for age, and multiple regression analysis. RESULTS The mean 10-year CHD and 10-year stroke risks were 14.92±11.53% and 4.03±3.95%, respectively. The 10-year CHD risk correlated with CIMT (P<0.001), FMD (P=0.017), and PWV (P=0.35) after adjusting for age. The 10-year stroke risk correlated only with the mean CIMT (P<0.001) after adjusting for age. FMD correlated with age (P<0.01) and systolic blood pressure (P=0.09). CIMT correlated with age (P<0.01), HbA1c (P=0.05), and gender (P<0.01). CONCLUSION The CVD risk is increased at the onset of type 2 diabetes. CIMT, FMD, and PWV along with the UKPDS risk engine should be considered to evaluate cardiovascular disease risk in patients with newly diagnosed type 2 diabetes.
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Affiliation(s)
- Choon Sik Seon
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
| | - Kyung Wan Min
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
- Diabetes Clinic, Eulji Medical Center, Seoul, Korea
| | - Seung Yup Lee
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
| | - Kyoung Woo Nho
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
| | - Se Hwan Park
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
| | - Bo Kyung Koo
- Department of Internal Medicine, Boramae Hospital, Seoul, Korea
| | - Kyung Ah Han
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
- Diabetes Clinic, Eulji Medical Center, Seoul, Korea
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84
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Endothelial function and carotid intima-medial thickness in adolescents with type 2 diabetes mellitus. J Pediatr 2011; 159:971-4. [PMID: 21722916 DOI: 10.1016/j.jpeds.2011.05.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 04/13/2011] [Accepted: 05/13/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We assessed the effect of type 2 diabetes mellitus and obesity on flow-mediated dilation (FMD) and endothelial-dependent vasodilation and carotid intima-medial thickness (cIMT) in young people. STUDY DESIGN Adolescents were recruited in 3 groups: subjects with type 2 diabetes mellitus (n = 15), subjects who were obese and non-insulin resistant (n = 13), and lean control subjects (n = 13). Body mass index was similar in subjects with obesity and subjects with type 2 diabetes mellitus, but higher compared with that of lean control subjects (both P < .001). Brachial artery FMD and cIMT were assessed by using Duplex ultrasound scanning imaging. RESULTS There were no significant differences in brachial or common carotid arterial diameters in the groups. cIMT was significantly greater in the group with type 2 diabetes mellitus (0.54 ± 0.01mm) compared with both the lean control (0.46 ± 0.02 mm, P < .001) and obese control (0.46 ± 0.02 mm, P < .01) groups. FMD was significantly decreased in the group with type 2 diabetes mellitus (7.98% ± 0.54%) compared with the lean group (10.40% ± 1.00%, P < .05). CONCLUSIONS Measures of vascular health were impaired in adolescents with type 2 diabetes mellitus compared with lean and obese adolescents who were not insulin resistant. Measures of arterial function and structure may provide pre-clinical measures of cardiovascular disease in young people at elevated risk.
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85
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Reijmer YD, van den Berg E, Dekker JM, Nijpels G, Stehouwer CD, Kappelle L, Biessels GJ. The metabolic syndrome, atherosclerosis and cognitive functioning in a non-demented population: The Hoorn Study. Atherosclerosis 2011; 219:839-45. [DOI: 10.1016/j.atherosclerosis.2011.08.032] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 08/17/2011] [Accepted: 08/18/2011] [Indexed: 10/17/2022]
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Affiliation(s)
- Fadi G Hage
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA.
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87
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Shantsila E, Wrigley B, Shantsila A, Tapp LD, Blann AD, Gill PS, Lip GYH. Ethnic differences in macrovascular and microvascular function in systolic heart failure. Circ Heart Fail 2011; 4:754-62. [PMID: 21914813 DOI: 10.1161/circheartfailure.111.962365] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Endothelial dysfunction is implicated in the pathophysiological features of heart failure (HF), and ethnic differences in the presentation of cardiovascular disease are evident, with an excess seen among South Asians (SAs). However, data on ethnic differences in endothelial function in HF are limited. METHODS AND RESULTS In a cross-sectional study, we recruited 128 subjects with systolic HF: 50 SAs, 50 whites, and 28 African Caribbeans (ACs). In addition, SAs with systolic HF were compared with 40 SAs with coronary artery disease without HF ("disease controls") and 40 SA healthy controls. Macrovascular endothelial function was assessed by measurement of flow-mediated dilation (FMD) in response to hyperemia, arterial stiffness was assessed by the pulse-wave velocity, and microvascular endothelial function was assessed by forearm laser Doppler flowmetry. CD144-expressing endothelial microparticles were measured by flow cytometry. When compared with disease controls and healthy controls, SAs with HF had an impaired microvascular response to acetylcholine (P=0.001) and reduced FMD (P<0.001). In comparing ethnic groups, SAs with HF had an impaired response to acetylcholine (123±95.5%) compared with whites (258±156%) and ACs (286±173%, P<0.001 for both). Whites had a higher FMD (8.49±4.63%) than SAs (4.76±4.78%, P<0.001) and ACs (4.55±3.56%, P=0.01). No difference in endothelial-independent response was observed between study groups or in pulse-wave velocity. Ethnicity remained associated with microvascular endothelial function even after adjustment for age, presence of hypertension and diabetes mellitus, blood pressure, and glucose levels (P=0.003). There were no differences in numbers of endothelial microparticles. CONCLUSIONS The SAs with HF have impaired microvascular and macrovascular endothelial function but preserved arterial elastic properties. Significant ethnic differences in endothelial function are evident in subjects with HF, with ethnicity being associated with microvascular endothelial dysfunction in this disorder.
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Affiliation(s)
- Eduard Shantsila
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK.
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Bruno RM, Daghini E, Landini L, Versari D, Salvati A, Santini E, Di Paco I, Magagna A, Taddei S, Ghiadoni L, Solini A. Dynamic evaluation of renal resistive index in normoalbuminuric patients with newly diagnosed hypertension or type 2 diabetes. Diabetologia 2011; 54:2430-9. [PMID: 21499674 DOI: 10.1007/s00125-011-2148-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 03/18/2011] [Indexed: 02/03/2023]
Abstract
AIM/HYPOTHESIS Renal resistive index is a useful measure for quantifying alterations in renal blood flow. In the present study we evaluated resistive index at baseline and after vasodilation induced by nitroglycerine in normoalbuminuric patients with type 2 diabetes or essential hypertension, relating the values to indices of systemic vascular dysfunction. METHODS Newly diagnosed treatment-naïve type 2 diabetic (n = 32) and hypertensive patients (n = 49) were compared with 27 age- and sex-matched healthy controls. Renal resistive index was obtained by duplex ultrasound at baseline and after 25 μg sublingual nitroglycerine. Endothelium-dependent (flow-mediated dilation) and -independent (response to nitroglycerine) vasodilation in the brachial artery was assessed by computerised edge detection system. Carotid-femoral pulse-wave velocity and augmentation index were assessed by applanation tonometry. Nitrotyrosine levels, an index of oxidative stress, were also measured. RESULTS Resistive index was higher in diabetic than in hypertensive patients and controls (p < 0.001), while changes in resistive index induced by nitroglycerine were lower in hypertensive patients compared with controls (p < 0.01), and were further reduced in type 2 diabetic patients. Hypertensive and diabetic patients showed significantly increased arterial stiffness, nitrotyrosine levels and reduced endothelial function than controls (p < 0.05). Changes in resistive index induced by nitroglycerine were independently related to serum glucose, reactive hyperaemia and aortic pulse-wave velocity in the overall population. CONCLUSIONS/INTERPRETATION These results support the dynamic evaluation of renal resistive index as an early detector of renal vascular alterations in the presence of type 2 diabetes and hypertension, even before the onset of microalbuminuria.
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Affiliation(s)
- R M Bruno
- Department of Internal Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
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Lorbeer R, Empen K, Dörr M, Arndt M, Schipf S, Nauck M, Wallaschofski H, Felix SB, Völzke H. Association between glycosylated haemoglobin A1c and endothelial function in an adult non-diabetic population. Atherosclerosis 2011; 217:358-63. [DOI: 10.1016/j.atherosclerosis.2011.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 03/18/2011] [Accepted: 04/07/2011] [Indexed: 11/24/2022]
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90
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Kakko T, Jaakkola U, Raitakari OT, Kallio J. Inflammatory effects of blood leukocytes: association with vascular function in neuropeptide Y proline 7-genotyped type 2 diabetes patients. Diab Vasc Dis Res 2011; 8:221-8. [PMID: 21746772 DOI: 10.1177/1479164111415882] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We investigated the associations of inflammatory blood cell activation with vascular parameters in patients with type 2 diabetes to elucidate the possible mechanisms of accelerated atherosclerosis observed in subjects with the Leucine 7 to Proline 7 polymorphism (Leu7Pro) in the neuropeptide Y (NPY). METHODS Our study included 31 Caucasian patients with type 2 diabetes; 12 of them had the Leu7Pro7 (heterozygous), and 19 had the Leu7Leu7 (wild type) genotype. Vascular parameters were determined by ultrasound methods. Leukocyte analyses were performed from blood samples using flow cytometry. NPY concentrations were determined in plasma. RESULTS The amount of platelet-granulocyte complexes was positively correlated with NPY concentration (p=0.008) and carotid intima-media thickness (p=0.035) in the Leu7Pro7 group. Interferon gamma (IFN-γ) expression in monocytes correlated negatively with brachial artery flow-mediated dilatation also in the Leu7Pro7 group (p=0.037). The expression of tissue factor on monocytes correlated negatively with brachial artery diameter in the Leu7Pro7 patients as well (p=0.019). CONCLUSION The results indicate significant associations between inflammatory cell activation in blood and vascular atherosclerosis in genetically prone subjects, and provide possible mechanistic information about the role of NPY and the Leu7Pro polymorphism in the development of atherosclerosis.
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91
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Chandran DS, Jaryal AK, Jyotsna VP, Deepak KK. Impaired endothelium mediated vascular reactivity in endogenous Cushing's syndrome. Endocr J 2011; 58:789-99. [PMID: 21778615 DOI: 10.1507/endocrj.ej11-0030] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Endogenous Cushing's syndrome (CS) is associated with a high incidence of cardiovascular morbidity and mortality resulting from the co-existence of multiple cardiovascular risk factors which probably induce a state of endothelial dysfunction. Recently, studies conducted in vitro as well as in normal human subjects suggest a direct role of cortisol in the causation of vascular dysfunction in this disorder. We non-invasively assessed the vascular reactivity and its potential association with elevated cortisol levels in patients of CS. A single time point observational study was conducted in 18 patients of CS and 15 age and gender matched healthy subjects. Vascular reactivity was assessed non-invasively by measuring the peripheral pulse wave form changes during reactive hyperemia (RH) using digital photoplethysmography (PPG). Parameters measured were pulse wave form amplitude (PWA), slope and pulse transit time (PTT). Maximal percentage changes in PWA during RH with reference to baseline were significantly lower in the patients as compared to controls [23.19% (13.19-53.54) vs 61.71% (38.21-95.36); p=0.0079]. Normalized PTT responses during the 1(st) minute of RH were blunted in the patients as compared to controls (1.036 ± 0.026 vs 1.056 ± 0.029; p=0.0425). Percentage changes in PTT during the 2(nd) minute of RH were negatively correlated to the morning cortisol levels in patients (r = -0.6328; p=0.0064). The present study showed that endothelium mediated vascular reactivity along with myogenic regulation of vascular tone is impaired in CS. Hypercortisolism possibly plays an important role in the causation of impaired vascular reactivity and endothelial dysfunction in CS.
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Affiliation(s)
- Dinu S Chandran
- Department of Physiology, All India Institute of Medical Sciences, Ansari Nagal, New Delhi, India
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Dogan A, Yarlioglues M, Kaya MG, Karadag Z, Dogan S, Ardic I, Dogdu O, Kilinc Y, Zencir C, Akpek M, Ozdogru I, Oguzhan A, Kalay N. Effect of long-term and high-dose allopurinol therapy on endothelial function in normotensive diabetic patients. Blood Press 2010; 20:182-7. [PMID: 21133824 DOI: 10.3109/08037051.2010.538977] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Endothelial dysfunction is a well known risk factor for atherosclerosis. Uric acid levels are associated with endothelial dysfunction and atherosclerosis even if in physiological range. Xanthine oxidase inhibition with allopurinol decreases uric acid levels and oxidative stress and improves endothelial function. We have investigated the effect of high-dose and long-term allopurinol therapy on endothelial function in diabetic normotensive patients. METHODS This study is a randomized, single-blind, placebo-controlled trial. Both treatment and placebo groups consisted of 50 patients. In the treatment group, daily oral 900 mg allopurinol was started after randomization and maintained for 12 weeks. Brachial artery flow-mediated dilatation (FMD) and nitrate-induced dilatation (NID) were measured at baseline and after the allopurinol therapy to evaluate endothelial function. RESULTS HbA1c and uric acid levels decreased after allopurinol therapy (6.1 ± 2.1 vs 5.5 ± 1.0%, 5.0 ± 0.8 vs 3.3 ± 0.5 mg/dl, respectively, p = 0.01) but no change was observed in the placebo group (7.7 ± 1.9% vs 7.6 ± 2.0%, 5.3±2.1 vs 5.6 ± 0.8 mg/dl, respectively, p > 0.05). FMD and NID increased significantly in the treatment group (5.6 ± 2.1% vs 8.5 ± 1.2%, 10 ± 7.4% vs 14 ± 4.0%, 10 ± 7.4% vs 14 ± 4.0%, respectively, p = 0.01), whereas no change was observed in the placebo group (5.8 ± 1.8% vs 6.1 ± 0.8%, 12 ± 9.5 vs 10 ± 3.8%, respectively, p > 0.05). CONCLUSION Long-term and high-dose allopurinol therapy significantly improved endothelial function in diabetic normotensive patients. In addition, allopurinol therapy contributes to the lower HbA1c levels.
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Affiliation(s)
- Ali Dogan
- Department of Cardiology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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93
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van der Zwan LP, Teerlink T, Dekker JM, Henry RMA, Stehouwer CDA, Jakobs C, Heine RJ, Scheffer PG. Plasma myeloperoxidase is inversely associated with endothelium-dependent vasodilation in elderly subjects with abnormal glucose metabolism. Metabolism 2010; 59:1723-9. [PMID: 20580782 DOI: 10.1016/j.metabol.2010.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 04/13/2010] [Accepted: 04/14/2010] [Indexed: 02/07/2023]
Abstract
Myeloperoxidase (MPO), a biomarker related to inflammation, oxidative stress, and nitric oxide scavenging, has been shown to impair endothelium-dependent vasodilation. Because elevated hydrogen peroxide concentrations in diabetic vessels may enhance MPO activity, we hypothesized that a stronger association of MPO with flow-mediated dilation (FMD) may be found in subjects with abnormal glucose metabolism. Myeloperoxidase concentrations were measured in EDTA plasma samples from participants of a population-based cohort study, including 230 subjects with normal glucose metabolism and 386 with abnormal glucose metabolism. Vascular function was expressed as FMD and nitroglycerin-mediated dilation of the brachial artery. In subjects with abnormal glucose metabolism, MPO was negatively associated with FMD (-20.9 [95% confidence interval {CI}, -41.7 to -0.2] -μm change in FMD per SD increment of MPO). This association remained significant after adjustment for nitroglycerin-mediated dilation (-31.1 [95% CI, -50.0 to -12.3]) and was not attenuated after further adjustment for established risk factors. In subjects with normal glucose metabolism, MPO was not significantly associated with FMD (2.0 [95% CI, -16.0 to 20.0]). In conclusion, in subjects with abnormal glucose metabolism, plasma levels of MPO are inversely associated with endothelium-dependent vasodilation, possibly reflecting enhancement of MPO activity by vascular oxidative stress.
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Affiliation(s)
- Leonard P van der Zwan
- Metabolic Laboratory, Department of Clinical Chemistry, VU University Medical Center, PO Box 7057, 1007MB Amsterdam, The Netherlands
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94
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Hueb W, Lopes N, Soares PR, Gersh BJ, Lima EG, Vieira RDO, Garzillo CL, Garcia RR, Pereira AC, Strunz CM, Meneguetti C, Tsutsui J, Parga J, Lemos P, Hueb A, Ushida A, Maranhão R, Chamone DA, Ramires JA. Hypotheses, rationale, design, and methods for prognostic evaluation in type 2 diabetic patients with angiographically normal coronary arteries. The MASS IV-DM Trial. BMC Cardiovasc Disord 2010; 10:47. [PMID: 20920271 PMCID: PMC2956708 DOI: 10.1186/1471-2261-10-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 09/29/2010] [Indexed: 11/15/2022] Open
Abstract
Background The MASS IV-DM Trial is a large project from a single institution, the Heart Institute (InCor), University of São Paulo Medical School, Brazil to study ventricular function and coronary arteries in patients with type 2 diabetes mellitus. Methods/Design The study will enroll 600 patients with type 2 diabetes who have angiographically normal ventricular function and coronary arteries. The goal of the MASS IV-DM Trial is to achieve a long-term evaluation of the development of coronary atherosclerosis by using angiograms and coronary-artery calcium scan by electron-beam computed tomography at baseline and after 5 years of follow-up. In addition, the incidence of major cardiovascular events, the dysfunction of various organs involved in this disease, particularly microalbuminuria and renal function, will be analyzed through clinical evaluation. In addition, an effort will be made to investigate in depth the presence of major cardiovascular risk factors, especially the biochemical profile, metabolic syndrome inflammatory activity, oxidative stress, endothelial function, prothrombotic factors, and profibrinolytic and platelet activity. An evaluation will be made of the polymorphism as a determinant of disease and its possible role in the genesis of micro- and macrovascular damage. Discussion The MASS IV-DM trial is designed to include diabetic patients with clinically suspected myocardial ischemia in whom conventional angiography shows angiographically normal coronary arteries. The result of extensive investigation including angiographic follow-up by several methods, vascular reactivity, pro-thrombotic mechanisms, genetic and biochemical studies may facilitate the understanding of so-called micro- and macrovascular disease of DM.
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Affiliation(s)
- Whady Hueb
- Heart Institute of the University of São Paulo, São Paulo, Brazil.
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95
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Reyes-Soffer G, Holleran S, Di Tullio MR, Homma S, Boden-Albala B, Ramakrishnan R, Elkind MS, Sacco RL, Ginsberg HN. Endothelial function in individuals with coronary artery disease with and without type 2 diabetes mellitus. Metabolism 2010; 59:1365-71. [PMID: 20102776 PMCID: PMC2891205 DOI: 10.1016/j.metabol.2009.12.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 12/18/2009] [Accepted: 12/21/2009] [Indexed: 01/22/2023]
Abstract
The goal of this study was to determine if individuals with coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM) had greater endothelial dysfunction (ED) than individuals with only CAD. Flow-mediated dilation (FMD), calculated as percentage increase in brachial artery diameter in response to postischemic blood flow, was measured after an overnight fast in 2 cohorts. The first cohort included 76 participants in the Northern Manhattan Study with CAD; 25 also had T2DM. The second cohort was composed of 27 individuals with both T2DM and CAD who were participants in a study of postprandial lipemia. Combined, we analyzed 103 patients with CAD: 52 with T2DM (T2DM+) and 51 without T2DM (T2DM-). The 52 CAD T2DM+ subjects had a mean FMD of 3.9% +/- 3.2%, whereas the 51 CAD T2DM- subjects had a greater mean FMD of 5.5% +/- 4.0% (P < .03). An investigation of various confounders known to affect FMD identified age and body mass index as the only significant covariates in a multiple regression model. Adjusting for age and body mass index, we found that FMD remained lower in T2DM+ subjects compared with T2DM- subjects (difference, -1.99%; P < .03). In patients with CAD, the concomitant presence of T2DM is independently associated with greater ED, as measured by FMD. This finding may be relevant to the greater early and late morbidity and mortality observed in patients with both CAD and T2DM.
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Affiliation(s)
| | - Steve Holleran
- Department of Pediatrics, Columbia University, Medical Center, New York, NY
| | - Marco R. Di Tullio
- Department of Cardiology, Columbia University, Medical Center, New York, NY
| | - Shunichi Homma
- Department of Cardiology, Columbia University, Medical Center, New York, NY
| | | | | | - Mitchell S. Elkind
- Department of Neurology, Columbia University, Medical Center, New York, NY
| | - Ralph L. Sacco
- Department of Neurology, Columbia University, Medical Center, New York, NY
| | - Henry N. Ginsberg
- Department of Medicine, Columbia University, Medical Center, New York, NY
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96
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Kuwabara A, Satoh M, Tomita N, Sasaki T, Kashihara N. Deterioration of glomerular endothelial surface layer induced by oxidative stress is implicated in altered permeability of macromolecules in Zucker fatty rats. Diabetologia 2010; 53:2056-65. [PMID: 20526760 PMCID: PMC2910881 DOI: 10.1007/s00125-010-1810-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 05/06/2010] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS The glomerular endothelial layer is coated by the endothelial surface layer (ESL), which is suggested to play a role in regulation of the permselectivity of macromolecules. Production of heparanase, a degrading enzyme of the ESL, is induced by reactive oxygen species (ROS). We hypothesised that oxidative stress could cause deterioration of the glomerular ESL by induction of heparanase, resulting in increased glomerular permeability. METHODS Male Zucker fatty (ZF) rats with albuminuria and Zucker lean (ZL) rats were used in this study. Some of the ZF rats were treated with the angiotensin II receptor blocker, irbesartan. We determined the amount of ESL by wheat germ agglutinin staining and heparan sulphate proteoglycan production by western blot analysis. Glomerular hyperfiltration of macromolecules was visualised using in vivo microscopy. We used 2',7'-dichlorofluorescein diacetate-derived chemiluminescence staining to assess ROS production, and heparanase production and expression were determined by western blot analysis and quantitative real-time polymerase chain reaction respectively. RESULTS By 18 weeks of age, ZF rats had developed albuminuria. The glomerular endothelial cell glycocalyx was significantly decreased in ZF compared with ZL rats. Glomerular filtration and the permeability of macromolecules were increased in ZF, but not in ZL rats. Glomerular ROS and heparanase production were significantly increased in ZF compared with ZL rats. These changes in ZF rats were reversed by irbesartan treatment. CONCLUSIONS/INTERPRETATION Increased oxidative stress induces glomerular ESL deterioration in part through increased heparanase levels, resulting in exacerbation of glomerular permselectivity and development of albuminuria.
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Affiliation(s)
- A. Kuwabara
- Division of Nephrology and Hypertension, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192 Japan
| | - M. Satoh
- Division of Nephrology and Hypertension, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192 Japan
| | - N. Tomita
- Division of Nephrology and Hypertension, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192 Japan
| | - T. Sasaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192 Japan
| | - N. Kashihara
- Division of Nephrology and Hypertension, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192 Japan
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97
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Diabetes impairs arteriogenesis in the peripheral circulation: review of molecular mechanisms. Clin Sci (Lond) 2010; 119:225-38. [PMID: 20545627 DOI: 10.1042/cs20100082] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Patients suffering from both diabetes and PAD (peripheral arterial disease) are at risk of developing critical limb ischaemia and ulceration, and potentially requiring limb amputation. In addition, diabetes complicates surgical treatment of PAD and impairs arteriogenesis. Arteriogenesis is defined as the remodelling of pre-existing arterioles into conductance vessels to restore the perfusion distal to the occluded artery. Several strategies to promote arteriogenesis in the peripheral circulation have been devised, but the mechanisms through which diabetes impairs arteriogenesis are poorly understood. The present review provides an overview of the current literature on the deteriorating effects of diabetes on the key players in the arteriogenesis process. Diabetes affects arteriogenesis at a number of levels. First, it elevates vasomotor tone and attenuates sensing of shear stress and the response to vasodilatory stimuli, reducing the recruitment and dilatation of collateral arteries. Secondly, diabetes impairs the downstream signalling of monocytes, without decreasing monocyte attraction. In addition, EPC (endothelial progenitor cell) function is attenuated in diabetes. There is ample evidence that growth factor signalling is impaired in diabetic arteriogenesis. Although these defects could be restored in animal experiments, clinical results have been disappointing. Furthermore, the diabetes-induced impairment of eNOS (endothelial NO synthase) strongly affects outward remodelling, as NO signalling plays a key role in several remodelling processes. Finally, in the structural phase of arteriogenesis, diabetes impairs matrix turnover, smooth muscle cell proliferation and fibroblast migration. The review concludes with suggestions for new and more sophisticated therapeutic approaches for the diabetic population.
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98
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Tziomalos K, Athyros VG, Karagiannis A, Mikhailidis DP. Endothelial dysfunction in metabolic syndrome: prevalence, pathogenesis and management. Nutr Metab Cardiovasc Dis 2010; 20:140-146. [PMID: 19833491 DOI: 10.1016/j.numecd.2009.08.006] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 06/09/2009] [Accepted: 08/03/2009] [Indexed: 11/16/2022]
Abstract
The metabolic syndrome (MetS) is characterized by the presence of central obesity, impaired glucose metabolism, dyslipidemia and hypertension. Several studies showed that MetS is associated with increased risk for type 2 diabetes mellitus (T2DM) and vascular events. All components of MetS have adverse effects on the endothelium. Endothelial dysfunction plays a role in the pathogenesis of atherosclerosis and might also increase the risk for insulin resistance and T2DM. We review the prevalence and pathogenesis of endothelial dysfunction in MetS. We also discuss the potential effects of lifestyle measures and pharmacological interventions on endothelial function in these patients. It remains to be established whether improving endothelial function in MetS will reduce the risk for T2DM and vascular events.
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Affiliation(s)
- K Tziomalos
- Department of Clinical Biochemistry (Vascular Prevention Clinic), Royal Free Hospital Campus, University College Medical School, University College London (UCL), London, UK
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99
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Kiyici S, Ersoy C, Kaderli A, Fazlioglu M, Budak F, Duran C, Gul OO, Sigirli D, Baran I, Tuncel E, Erturk E, Imamoglu S. Effect of rosiglitazone, metformin and medical nutrition treatment on arterial stiffness, serum MMP-9 and MCP-1 levels in drug naive type 2 diabetic patients. Diabetes Res Clin Pract 2009; 86:44-50. [PMID: 19674806 DOI: 10.1016/j.diabres.2009.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Revised: 07/07/2009] [Accepted: 07/13/2009] [Indexed: 11/29/2022]
Abstract
The aim of the study was to evaluate the long-term effect of rosiglitazone and metformin monotherapy with medical nutrition treatment (MNT) and of MNT alone on arterial stiffness, serum monocyte chemoattractant protein (MCP)-1 and matrix metalloproteinase (MMP)-9 in drug naive patients with type 2 diabetes mellitus. Fifty type 2 diabetic patients were randomized to receive rosiglitazone 4 mg/day (n=19) or metformin 850 mg/day (n=16) with MNT or MNT alone (n=15), for 52 weeks. Arterial stiffness was assessed by using large and small artery elasticity index (SAEI and LAEI, respectively). SAEI, LAEI, serum MCP-1 and MMP-9 levels were measured at baseline and following 52 weeks of treatment. SAEI was improved only in the rosiglitazone group, and the difference was still statistically significant when the three groups were compared (p=0.024). There were no differences in LAEI in inter- and intragroup comparisons at the end of the study. Serum MMP-9 levels were decreased in the metformin (-13.5+/-34.8%, p=0.02) and rosiglitazone (-27.2+/-51.0%, p=0.023) groups compared with baseline values, whereas no significant change was seen in serum MCP-1 levels. These results suggest that rosiglitazone monotherapy has favorable effects on arterial stiffness compared with metformin monotherapy independent of glycemic control.
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Affiliation(s)
- Sinem Kiyici
- Uludag University, Medical Faculty, Department of Endocrinology and Metabolism, Bursa 16059, Turkey.
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100
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Plasma levels of soluble receptor for advanced glycation end products are associated with endothelial function and predict cardiovascular events in nondiabetic patients. Coron Artery Dis 2009; 20:267-73. [DOI: 10.1097/mca.0b013e32832c459c] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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