title: Endothelial dysfunction of conduit arteries in insulin-dependent diabetes mellitus without microalbuminuria.
abstract: OBJECTIVE
  Previous studies have shown that endothelial dysfunction, an early sign of atherosclerosis, occurs in animal models of diabetes mellitus and in resistance vessels of patients with insulin-dependent diabetes. In the present study we examined whether young patients with insulin-dependent diabetes without microalbuminuria present abnormal endothelial function of large peripheral arteries.
  
  
  METHODS
  Twenty-six patients with insulin-dependent diabetes without microalbuminuria were compared with 26 normal controls and 5 patients with insulin-dependent diabetes with microalbuminuria. Brachial artery diameter was measured at rest, during reactive hyperaemic flow (endothelium-dependent dilatation) and after sublingual isosorbide dinitrate (endothelium-independent dilatation).
  
  
  RESULTS
  Baseline artery diameter and flow as well as the degree of reactive hyperaemia were similar in all groups compared to controls. Flow-mediated dilatation was lower in patients with diabetes without microalbuminuria (5.8 +/- 7 vs 11 +/- 7%. P = 0.01) as well as in patients with diabetes without microalbuminuria (0.75 +/- 2.5 vs 11 +/- 7%, P = 0.003); nitrate-induced dilatation was normal in patients without microalbuminuria and attenuated in patients with microalbuminuria. In the group of diabetes patients without microalbuminuria, those with disease duration > 10 years and HbAlc > 6% had the worse endothelial function.
  
  
  CONCLUSIONS
  Our results demonstrate that endothelial dysfunction of conduit arteries can be detected in patients with insulin-dependent diabetes mellitus without microalbuminuria, probably contributing to the high prevalence of atherosclerosis in these patients.
authors.affiliation: Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Lekakis
authors.forename: C
authors.initials: C
authors.lastname: Papamichael
authors.forename: H
authors.initials: H
authors.lastname: Anastasiou
authors.forename: M
authors.initials: M
authors.lastname: Alevizaki
authors.forename: N
authors.initials: N
authors.lastname: Desses
authors.forename: A
authors.initials: A
authors.lastname: Souvatzoglou
authors.forename: S
authors.initials: S
authors.lastname: Stamatelopoulos
authors.forename: D A
authors.initials: DA
authors.lastname: Koutras
mesh_terms: D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000473:pathology / Q000503:physiopathology; D001916:Brachial Artery / Q000187:drug effects / Q000473:pathology*; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000473:pathology / Q000503:physiopathology; D007548:Isosorbide Dinitrate / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D013997:Time Factors; D014664:Vasodilation / Q000187:drug effects*; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate