Journal List > J Korean Diabetes Assoc > v.31(6) > 1062478

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Choi, Min, Kim, Koo, Lim, Kim, Pak, Han, and Kim: Relationship between Endothelial-dependent/-independent Vasodilation and Carotid Intimal-media Thickness in Newly-diagnosed Korean Type 2 Diabetic Patients
Original Articles
The Journal of Korean Diabetes Association

The Journal of Korean Diabetes Association 2007; 31(6): 498-506.

Published online: 30 November 2007

DOI: https://doi.org/10.4093/jkda.2007.31.6.498

Relationship between Endothelial-dependent/-independent Vasodilation and Carotid Intimal-media Thickness in Newly-diagnosed Korean Type 2 Diabetic Patients

Jung-Ho Choi, Kyung Wan Min, Hyo-Jeong Kim, Bo kyung Koo, Chae Young Lim, Hyun-Jin Kim, Gang Seo Pak, Kyung Ah Han, Eung Jin Kim

Department of Internal Medicine, Eulji University School of Medicine, Korea.

Received 5 September 2007       Accepted 31 October 2007

Copyright © 2007 Korean Diabetes Association

Abstract

Background

The relative effect of diabetes on the risk of cardiovascular disease in Asian population is much the same as that in Western populations. Although multiple atherosclerotic risk factors have been documented in Asia, precise estimates of vascular reactivity might provide more critical informations for the prevention and the control of diabetes-related cardiovascular mortality and morbidity. The aims of this study were to estimate the vascular reactivity directly and evaluate its relationship with other cardiovascular risk factors and carotid intimal-media thickness (IMT) in newly-diagnosed Korean type 2 diabetic patients.

Methods

We measured flow-mediated vasodilation (FMD) and endothelial-independent vasodilation (EID) of the brachial artery using high-resolution ultrasonography in total of 121 (M; N = 68, F; N = 53) diabetic patients. We assessed conventional cardiovascular risk factors such as age, smoking, obesity, hypertension, hyperlipidemia or family history of cardiovascular disease and analyzed the association among FMD/EID with cardiovascular risk factors, carotid IMT or the total number of risk factors.

Results

The mean values of age, smoking, BMI, waist, systolic blood pressure and diastolic blood pressure were 51.2 ± 12.3 years, 11.0 ± 15.8 pack years, 25.0 ± 3.2 kg/m2, 86 ± 9 cm, 123 ± 16 mmHg and 79 ± 12 mmHg. The mean values of HbA1c, fasting blood glucose, total cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol were 8.4 ± 2.0%, 166 ± 51 mg/dL, 187 ± 37 mg/dL, 166 ± 143 mg/dL, 114 ± 30 mg/dL and 46 ± 12 mg/dL. FMD and EID were estimated by 6.1 ± 2.8% and 16.6 ± 5.6% respectively. The mean/maximal carotid IMT were 0.63 ± 0.12/0.76 ± 0.16 mm and the number of risk factors besides diabetes mellitus were 2.3 ± 1.3. After adjusting age, FMD was associated only with smoking, but EID was associated with smoking, systolic/diastolic blood pressure, mean/maximal carotid IMT and number of risk factors by partial correlations. Age, smoking and EID were independent risk variables for carotid IMT, analyzed by multiple regression test.

Conclusion

These findings suggest that impaired vascular reactivity detected by EID is closely related to carotid IMT, an useful surrogate marker for atherosclerosis, in newly-diagnosed Korean type 2 diabetic patients.

Keywords: Intimal-media thickness (IMT), Endothelial-independent vasodilation (EID), Flow-mediated vasodilation (FMD), Newly-diagnosed Type 2 Diabetes

Figures and Tables

Fig. 1
Prevalence of risk factors besides diabetes (A) and incidence of patients who had CVD risk factors (B).
jkda-31-498-g001
Fig. 2
Correlations between endothelium-independent vasodilation (EID) and mean carotid IMT (A) or number of CVD risk factors besides diabetes (B).
jkda-31-498-g002
Table 1
Clinical characteristics of 121 newly diagnosed diabetic patients
jkda-31-498-i001

BMI, body mass index; FPG, fasting plasma glucose; SBP, systolic blood pressure; DBP, diastolic blood pressure; FMD, flow-mediated vasodilation; EID, endothelium-independent vasodilation; IMT, carotid intimal-media thickness.

Table 2
Correlations among clinical variables with FMD or EID
jkda-31-498-i002

Ln_Triglyceride, Triglyceride transformed by log-scale. *P < 0.05. †P < 0.01. ‡P < 0.001. Analyzed by Pearsons' correlation test (r) and partial correlations [age-controlled(r)].

Table 3
Multiple regression analysis for mean carotid IMT as dependent variables
jkda-31-498-i003

Dependent variable: mean carotid IMT, r2 = 0.43 P < 0.001, Ln_Triglyceride, Triglyceride transformed by log-scale.

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