Plasma endothelin-1 concentrations in non-insulin-dependent diabetes mellitus and nondiabetic patients with chronic arterial obstructive disease of the lower limbs.
BACKGROUND
Endothelin-1 (ET-1), a vasoconstrictor and mitogenic endothelium-derived peptide, has been considered as a marker for endothelial damage and potential contributor to the development of the atherogenic process.


METHODS
To evaluate the pattern of plasma ET-1 secretion in non-insulin-dependent diabetes mellitus (NIDDM) and nondiabetic patients with chronic arterial obstructive disease (CAOD) of the lower limbs, plasma levels of ET-1 were determined in 12 NIDDM patients (10 men and 2 women; mean age 63+/-8 years) with CAOD of the lower limbs at Fontaine stage II and in 12 nondiabetic patients (11 men and 1 woman; mean age 62+/-4 years) with comparable arteriopathy. Ten normal subjects comprised the control population.


RESULTS
The plasma levels of ET-1 in NIDDM patients with CAOD of the lower limbs were 5.7+/-0.3 pmol/L, which represented a significant (p<0.001) difference from the values in nondiabetic patients with comparable arteriopathy (4.1+/-0.6 pmol/L) and those in the control group (2.7+/-0.7 pmol/L). Plasma levels of ET-1 showed a significant (p<0.0001) positive correlation with the levels of fasting insulin in NIDDM patients with CAOD of the lower limbs. Increased plasma ET-1 could reflect a major and/or more diffuse endothelial cell damage or dysfunction in NIDDM than in nondiabetic patients with comparable CAOD of the lower limbs. Augmented mitogenic ET-1 levels could also have a role both in diabetic and nondiabetic angiopathy.


CONCLUSIONS
The positive correlation between ET-1 plasma levels and fasting insulin levels in NIDDM patients with CAOD of the lower limbs suggests that the increased ET-1 release could be related to the augmented insulin secretion in these patients. Insulin-related overproduction of ET-1 could promote the atherogenic process and enhance the vascular tone to a greater extent in NIDDM than in nondiabetic patients with CAOD of the lower limbs.
Mangiafico
R A
RA
Institute of Internal Medicine L. Condorelli, University of Catania, Italy.
Malatino
L S
LS
Santonocito
M
M
Spada
R S
RS
D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000503:physiopathology; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000503:physiopathology; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged
D019332:Endothelin-1; D007328:Insulin