Impaired endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus
| Autor: | Mark A. Creager, Jorge A. Cusco, Shelly J. Creager, M T Johnstone, B K Lee, Kathleen M. Scales |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Blood Glucose Male Nitroprusside medicine.medical_specialty Endothelium Vasodilation Nitric Oxide Phenylephrine Physiology (medical) Internal medicine Diabetes mellitus medicine.artery medicine Humans Insulin Brachial artery Methacholine Chloride Glycated Hemoglobin business.industry medicine.disease Forearm Endocrinology medicine.anatomical_structure Diabetes Mellitus Type 1 Verapamil Female Sodium nitroprusside Endothelium Vascular Cardiology and Cardiovascular Medicine business Dyslipidemia Blood Flow Velocity Diabetic Angiopathies medicine.drug |
| Zdroj: | Circulation. 88(6) |
| ISSN: | 0009-7322 |
| Popis: | BACKGROUND Endothelium-dependent vasodilation is abnormal in experimental models of diabetes mellitus. We postulated that abnormalities of endothelial function are also present in patients with insulin-dependent diabetes mellitus and may contribute to the pathogenesis of vascular disease in these individuals. METHODS AND RESULTS Vascular reactivity was measured in the forearm resistance vessels of 15 patients with insulin-dependent diabetes mellitus and 16 age-matched normal subjects. No patient had hypertension or dyslipidemia. Each subject was pretreated with aspirin to inhibit endogenous production of prostanoids. Methacholine chloride (0.3 to 10 micrograms/min) was administered via the brachial artery to assess endothelium-dependent vasodilation. Sodium nitroprusside (0.3 to 10 micrograms/min) and verapamil (10 to 300 micrograms/min) were infused intra-arterially to assess endothelium-independent vasodilation; phenylephrine (0.3 to 3 micrograms/min) was administered to examine vasoconstrictor responsiveness. Forearm blood flow was determined by venous occlusion plethysmography, and dose-response curves were generated for each drug. Basal forearm blood flow in diabetic and normal subjects was comparable (2.6 +/- 0.2 versus 2.1 +/- 0.3 mL x 100 mL-1 x min-1, respectively; P = NS). The forearm vasodilative response to methacholine was less in diabetic than in normal subjects. At the highest dose of methacholine, the forearm blood flow increased 9.5 +/- 1.1 mL x 100 mL-1 x min-1 in diabetic subjects and 15.3 +/- 1.4 mL.100 mL-1 x min-1 in normal subjects (P < .01). The forearm blood flow responses to nitroprusside and verapamil and the forearm vasoconstrictor responses to phenylephrine were similar in diabetic and healthy subjects. In diabetic subjects, endothelium-dependent vasodilation correlated inversely with serum insulin concentration but not with glucose concentration, glycosylated hemoglobin, or duration of diabetes. CONCLUSIONS Endothelium-dependent vasodilation is abnormal in forearm resistance vessels of patients with insulin-dependent diabetes mellitus. This abnormality may be relevant to the high prevalence of vascular disease that occurs in these individuals. |
| Databáze: | OpenAIRE |
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