Endothelial Dysfunction and Microvascular Complications in Type 1 Diabetes Mellitus.
10.3346/jkms.2008.23.1.77
- Author:
Seon Mi JIN
1
;
Chung Il NOH
;
Sei Won YANG
;
Eun Jung BAE
;
Choong Ho SHIN
;
Hae Rim CHUNG
;
You Yeh KIM
;
Yong Soo YUN
Author Information
1. Department of Pediatrics, Seoul National University Children s Hospitall, Seoul, Korea. ksydhnoh@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Vascular Endothelial;
Atherosclerosis;
Microangiopathy;
Diabetes Mellitus
- MeSH:
Adult;
Diabetes Mellitus, Type 1/*complications;
Diabetic Angiopathies/*etiology;
Endothelium, Vascular/*physiology;
Female;
Humans;
Male;
*Microcirculation;
Tunica Intima/pathology;
Tunica Media/pathology;
Vasodilation
- From:Journal of Korean Medical Science
2008;23(1):77-82
- CountryRepublic of Korea
- Language:English
-
Abstract:
We examined whether alterations in vascular endothelial function and early structural changes in atherosclerosis are associated with microvascular complications in patients with type 1 diabetes mellitus (DM). Flow-mediated dilation (FMD) of the brachial artery and carotid intima-media thickness (IMT) measurement were performed in 70 young adults (aged 19 to 35 yr), 48 with type 1 DM, and 22 normal controls. Patients with diabetes had a lower peak FMD response (7.8+/-3.9 vs. 11.1 +/-1.9%, p<0.001) and increased IMT (0.51+/-0.10 vs. 0.42+/-0.07 mm, p<0.001) compared with controls. Twenty (41.7%) of the patients had microvascular complications including neuropathy, nephropathy, or retinopathy. In these complicated diabetic patients, we found a lower FMD response (6.1+/-2.5 vs. 9.9+/-3.5%, p=0.001) compared with diabetics without microvascular complications. The presence of microvascular complications was also associated with older age and longer duration of the disease. However, no differences were observed in IMT, body size, blood pressure, HbA1c, C-reactive protein, low-density lipoprotein or high-density lipoprotein cholesterol levels between complicated and non-complicated patients. Endothelial dysfunction and early structural atherosclerotic changes are common manifestations in type 1 DM, and endothelial dysfunction is thought to be an early event in the atherosclerotic process and important in the pathogenesis of microvascular complications.
