Endothelial Dysfunction Diagnostic “Platform” in patients with diabetes mellitus

Abstract

Objective: to determine the diagnostic signifi cance of endothelial dysfunction (ED) laboratory markers.Material and methods: we examined 276 men with type 2 diabetes mellitus (age 54.0[49;60] years). Patients underwent general clinical studies, analysis of carbohydrate and lipid metabolism parameters, adipohormones: leptin, resistin, adiponectin. Endothelial function was assessed by ultrasound examination of endothelium-dependent vasodilation (EDVD) of the brachial artery during a test with reactive hyperemia and determination of biochemical parameters of endothelial function — nitric oxide (NO), endothelial synthase NO type3, endothelin, ICAM-1, VCAM-1, p- and e-selectins, cadherin, PAI-1, VEGF-1, homocysteine B, C-reactive protein (CRP), osteoprotegerin. To assess the diagnostic signifi cance of the methods and to determine the cut-off , ROC analysis was used.Results: independent signifi cance in the diagnosis of ED was demonstrated by NO, ICAM-1, resistin (p<0.001), CRP (p=0.006). Th e odds ratio of ED for resistin was 6.97, which is 1.9 times higher than NO and ICAM-1 and 3.7 times higher than CRP. Th e cut-off  for diagnostic of ED are: NO — 97.3 μmol/L, ICAM-1 — 309.4 ng/ml, resistin — 6.32 ng/ml, CRP — 6.25 mg/L.Conclusion: the diagnostic platform for determining ED, along with the ultrasound assessment of EDVD, should include the analysis of its biochemical markers: NO, ICAM-1, resistin, CRP. Resistin is an independent, high-precision marker of ED, which is the pathogenetic link between endothelial dysfunction and adipose tissue dysmetabolism.