Impaired endothelial function as a common denominator of microvascular complications and atherosclerosis in type 2 diabetes
Document Actions
Many comorbidities in type 2 diabetes mellitus are associated with endothelial dysfunction (ED), the latter being increasingly viewed as a sentinel predictor of new-onset macroangiopathy. The prospective association between macroangiopathy, ED and microangiopathy in hyperglycaemic states is less documented. As it is not yet clear whether the presence of microangiopathy, such as diabetic retinopathy (DR), predicts atherosclerosis in patients with type 2 diabetes, this study aimed to investigate the association between DR and intima-media thickness (IMT), a surrogate marker of atherosclerosis. To this end, 182 consecutive patients with type 2 diabetes were followed-up for at least 5 years. IMT of carotid artery was assessed by ultrasound, and ED by flow-mediated dilatation (FMD) as well as by measuring concentrations of von Willebrand factor (vWF) and s-ICAM-1. IMT was significantly higher in patients with DR than in those without DR, whereas FMD was lower in patients with DR than in those without DR. There was no difference between both groups regarding the concentrations of s-ICAM-1 and vWF. Multiple regression analysis revealed that DR was a predictor of increased IMT and decreased FMD. No association was found between DR and concentrations of s-ICAM-1 and vWF. In conclusion, DR appears to be associated with increased IMT and ED in patients with type 2 diabetes.
Abstract
