Affiliation:
1. From the Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts; the 2Division of Cellular and Molecular Physiology, Joslin Diabetes Center, Boston, Massachusetts; and the 3Division of Endocrinology, Northwestern University, Chicago, Illinois
Abstract
OBJECTIVE—We examined the relationship between insulin resistance and vascular function in three insulin-resistant states (type 2 diabetes, non-HIV lipodystrophic diabetes, and nondiabetic polycystic ovary syndrome [PCOS]) and in healthy control subjects.
RESEARCH DESIGN AND METHODS—The population included 12 women with type 2 diabetes, 6 with lipodystrophic diabetes, 10 with PCOS, and 19 healthy female subjects. Metabolic measures included insulin sensitivity by the homeostasis model assessment, lipids, free fatty acids, and adiponectin. High-resolution B-mode ultrasound was used to determine endothelium-dependent and -independent vasodilation.
RESULTS—Type 2 diabetic, liposdystrophic, and PCOS subjects were insulin resistant compared with control subjects (P = 0.001). Flow-mediated vasodilation was reduced in diabetic (3.4 ± 1.3%) compared with control (7.3 ± 1.1%) subjects but not in lipodystrophic (7.7 ± 1.2%) or PCOS (9.9 ± 0.7%) subjects (P = 0.005). Nitroglycerin-mediated vasodilation was attenuated in both diabetic (15.2 ± 2.0%) and lipodystrophic (16.7 ± 3.6%) subjects compared with healthy control (24.6 ± 2.4%) and PCOS (23.2 ± 1.8%) subjects (P = 0.019). Insulin resistance, free fatty acids, adiponectin, or C-reactive protein did not associate with vascular dysfunction.
CONCLUSIONS—Among these different types of patients with insulin resistance, we found abnormal endothelium-dependent vasodilation only in the patients with type 2 diabetes. We postulate that variations in the mechanism of insulin resistance may affect endothelial function differently than glucose homeostasis.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
36 articles.
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