Obesity and Insulin Therapy as predictors of Endothelial Dysfunction in Type 2 Diabetes Mellitus with early CKD
https://doi.org/10.15605/jafes.041.S1
- Author:
Nursyahirah Ishak
1
;
Nur’ Aini Eddy Warman
1
;
Rohana Abd Ghani
1
Author Information
1. Universiti Teknologi MARA (UiTM)
- Publication Type:Journal Article
- MeSH:
Diabetes Mellitus, Type 2;
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):2-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Endothelial dysfunction (ED) is an early marker of atherosclerosis and plays a role in the pathophysiology of cardiovascular complications in type 2 diabetes mellitus (T2DM). Metabolic factors such as adiposity and insulin resistance
contribute to early vascular dysfunction, particularly in patients with preserved kidney function. This study aimed to
identify factors associated with ED in T2DM and early-stage chronic kidney disease (CKD)
Methodology:This study was conducted at Universiti Teknologi MARA (UiTM), Sungai Buloh, and involved 107 adults with T2DM
and estimated glomerular filtration rate ≥60 mL/min/1.73 m² (CKD stages 1–2). Endothelial function was assessed using
ultrasound-based brachial artery flow-mediated dilation (FMD), with ≤7.1% defining ED. Clinical, anthropometric,
metabolic, and renal parameters were compared between groups. Logistic regression analyses were performed to identify
independent predictors, with p-values <0.05 considered statistically significant.
Results:Of the cohort, 48.6% (n = 52) had abnormal FMD. They tended to have higher BMI (31.36 vs 28.38 kg/m², p = 0.020), larger
waist circumference (100.48 vs 94.53 cm, p = 0.026), and were more likely to be on insulin therapy (71.2 vs 49.1%, p =
0.020). The total daily insulin dose was higher in the abnormal FMD group (0.48 vs 0.35 U/kg), but this difference did not
reach statistical significance (p = 0.140). There were no significant differences in hemoglobin A1c, blood pressure, or renal
parameters. In multivariate analysis, BMI (adjusted OR 1.07, 95% CI 1.00–1.14, p = 0.037) and insulin therapy (adjusted OR
2.43, 95% CI 1.07–5.51, p = 0.034) remained independently associated.
Conclusion:In patients with T2DM and early CKD, higher BMI and insulin therapy are independently associated with ED. These findings
highlight the role of obesity and insulin resistance in early vascular dysfunction, emphasizing the importance of weighttargeted strategies alongside glycemic control and further identifying high-risk individuals to reduce cardiovascular risk.
- Full text:202607280828396624OP_A002.pdf
