Persistent arterial stiffness and endothelial dysfunction following successful pancreas-kidney transplantation in Type 1 diabetes
| Autor: | Martin G. Bischof, R. Prager, Oswald Wagner, E Theuer, Martin Auinger, Peter Quehenberger, Michael Wolzt, U Hanusch-Enserer, Thomas Kästenbauer, Marietta Stadler, C. Bieglmayer, Christian Anderwald |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism Vascular Cell Adhesion Molecule-1 Young Adult Endocrinology Heart Rate Internal medicine Diabetes mellitus Plasminogen Activator Inhibitor 1 Internal Medicine medicine Humans Endothelial dysfunction Pulse wave velocity Aged Aged 80 and over Vascular disease business.industry nutritional and metabolic diseases Stroke Volume Stroke volume Middle Aged medicine.disease Atherosclerosis Kidney Transplantation Transplantation Blood pressure Diabetes Mellitus Type 1 Treatment Outcome Case-Control Studies Arterial stiffness Cardiology Female Endothelium Vascular Pancreas Transplantation business E-Selectin Blood Flow Velocity Diabetic Angiopathies |
| Zdroj: | Diabetic medicine : a journal of the British Diabetic Association. 26(10) |
| ISSN: | 1464-5491 |
| Popis: | Successful simultaneous pancreas-kidney transplantation (SPK) in Type 1 diabetic (T1DM) patients results in improved cardiovascular outcome and survival. However, it is doubtful whether the impairment of cardiovascular and endothelial function in T1DM can be completely reversed.Pulse-wave velocity, stroke volume, heart rate, serological markers of endothelial dysfunction (soluble intercellular, vascular cell-adhesion molecules, E-selectin, and plasminogen-activator-inhibitor-1) were measured in 10 T1DM patients after SPK with non-diabetic glucose levels, 10 T1DM patients with poor [T1DM8; glycated haemoglobin (HbA1c)8%], and 10 with good glucose control (T1DM7, HbA1c7%), in 6 non-diabetic patients after kidney transplantation (KT) and 9 non-diabetic control subjects (CON), matching for major anthropometric characteristics.Pulse-wave velocity was increased in SPK (P0.02 vs. CON, KT, T1DM7) and in T1DM8 (P0.02 vs. T1DM7). Systolic blood pressure was increased in SPK (P0.05 vs. CON). Stroke volume was reduced in SPK, T1DM8 and T1DM7 and KT (P0.01 vs. CON). Heart rate was elevated in SPK and in T1DM8 (P0.0003 vs. CON and T1DM7). In SPK, soluble intercellular and vascular cell-adhesion molecules were 100% and 44% higher (P0.03 vs. CON), respectively, while plasminogen-activator-inhibitor-1 was decreased in SPK (P0.02 vs. CON).T1DM patients after SPK experience arterial stiffness, a higher heart-rate and blood pressure, reduced stroke volume and serological signs of endothelial dysfunction. Thus, functional and structural cardiovascular alterations as a result of glucotoxicity, uraemia and hypertension in T1DM might not be completely resolved by SPK. |
| Databáze: | OpenAIRE |
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