Comparison of degree of endothelial dysfunction in diabetic patients with and without dyslipidemia

Abstract

Atherosclerosis in patients with type 2 diabetes is multifactorial. Among other factors, dyslipidemia and increased levels of oxidized LDL are important pathogenic mechanisms of endothelial dysfunction in patients with diabetes. Non-invasive method of assessment of endothelial function by brachial artery flow-mediated vasodilatation (FMD), provided an extremely useful tool for clinical application. 90 patients attending the medicine and endocrinology departments were included in the study. Informed consent was obtained from all the study subjects. Clinical examination: Blood pressure (BP) and body-mass index (BMI); biochemical assessment, which included fasting blood sugar (FBS) and post-prandial blood sugar levels; and comprehensive lipid profile. The brachial artery diameter was measured on B-mode ultrasound images. FMD was calculated. Severe endothelial dysfunction was defined as FMD < 4.5%, as has been described. Data were collected and managed on an Excel worksheet. The average FMD among controls was 14.76±2.17%, and among diabetics was 7.17±5.1%. Within the dyslipidemia subgroup, FMD was markedly reduced with an average dilatation of 5.74±5.02. Severe endothelial dysfunction was prevalent in 26% of the diabetics. Endothelial dysfunction could not be demonstrated in controls. Among patients with diabetic dyslipidemia, the prevalence of ED was 41%. The present study findings may have implications about the origins of vascular disease in type 2 diabetes as well as patients with dyslipidemia. The ultrasound assessment of arterial FMD responses might provide a valuable tool for risk stratification of patients with type 2 diabetes, especially for those with dyslipidemia.