Original investigation

Cardiovascular Diabetology

, 11:127

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Determinants of vascular function in patients with type 2 diabetes

  • Katerina K NakaAffiliated withMichaelidion Cardiac Center, University of IoanninaDepartment of Cardiology, University of Ioannina
  • , Katerina PapathanassiouAffiliated withDepartment of Endocrinology, University of Ioannina
  • , Aris BechlioulisAffiliated withMichaelidion Cardiac Center, University of IoanninaDepartment of Cardiology, University of Ioannina
  • , Nikolaos KazakosAffiliated withMichaelidion Cardiac Center, University of IoanninaDepartment of Cardiology, University of Ioannina
  • , Konstantinos PappasAffiliated withMichaelidion Cardiac Center, University of IoanninaDepartment of Cardiology, University of Ioannina
  • , Stelios TigasAffiliated withDepartment of Endocrinology, University of Ioannina
  • , Dimitrios MakriyiannisAffiliated withDepartment of Endocrinology, Hatzikosta General Hospital
  • , Agathocles TsatsoulisAffiliated withDepartment of Endocrinology, University of Ioannina
  • , Lampros K MichalisAffiliated withMichaelidion Cardiac Center, University of IoanninaDepartment of Cardiology, University of IoanninaDepartment of Cardiology and Michaelidion Cardiac Centre, University of Ioannina Email author 

Abstract

Background

Type 2 diabetes mellitus (T2DM) is independently associated with an increased risk for cardiovascular diseases that is primarily due to the early development of advanced atherosclerotic vascular changes. The aim of our study was to investigate the predictors of vascular dysfunction in T2DM patients.

Methods

We studied 165 T2DM patients without known macrovascular or microvascular disease. Standard demographic (age, gender, cardiovascular risk factors, medications), clinical (body mass index, blood pressure) and laboratory (glucose, glycated hemoglobin, lipids, renal function) parameters were included in analyses. Brachial artery flow-mediated dilation (FMD), nitrate mediated dilation (NMD) and Carotid-Femoral Pulse Wave Velocity (PWV) were measured.

Results

Median age was 66 years and duration since T2DM diagnosis was 10 years, 70% were females and 79% hypertensives, while only 10% had a glycated hemoglobin <7%. FMD was positively associated with NMD (r 0.391, P < 0.001), while PWV was inversely associated with FMD (r -0.218, P = 0.014) and NMD (r -0.309, P < 0.001). Time since diagnosis of diabetes was the single independent predictor of FMD (β -0.40, P = 0.003). Increased age and fasting glucose and the presence of hypertension were independent predictors of decreased NMD (P < 0.001). Increased age and systolic blood pressure were independently associated with increased PWV (P < 0.001).

Conclusions

In T2DM patients, impairment of endothelium-dependent vasodilation was independently associated only with longer diabetes duration while no association with other established risk factors was found. Vascular smooth muscle dysfunction and increased arterial stiffness were more prominent in older T2DM patients with hypertension. Worse glycemic control was associated with impaired vascular smooth muscle function.

Keywords

Type 2 diabetes mellitus Pulse wave velocity Flow-mediated dilation Nitrate-mediated dilation Atherosclerosis