Carotid atherosclerosis in type 2 diabetes mellitus: potential role of endothelin-1, lipoperoxides, and prostacyclin.
Factors were studied that may initiate macroangiopathy or enhance or aggravate its pathogenesis in patients with type 2 diabetes mellitus. A total of 151 diabetics were compared with healthy controls (n=50); all patients and subjects were normotensive and without renal failure. Plasma endothelin-1 and free radical levels were measured. In addition, plasma prostacyclin levels were assessed by assaying its stable, spontaneous, breakdown product 6-keto-prostaglandin-F1a. Diabetics were divided into three groups: those with clinically evident macroangiopathy and those with early or without atherosclerosis (as determined by the carotid intima-media thickness. Plasma endothelin-1 levels were increased in all diabetics with atherosclerosis. Plasma free radical levels were increased in diabetics with macroangiopathy when compared with control subjects. The plasma levels of 6-keto-prostaglandin-F1a were slightly, but significantly, decreased in the diabetics with macroangiopathy when compared with control subjects. The carotid intima-media thickness was significantly greater in diabetics without macroangiopathy when compared with the controls. Furthermore, the intima-media thickness increased significantly in this group of diabetics but not in the controls over a 30-month follow-up period. Several factors may contribute to atherogenesis in diabetics. These include increased plasma endothelin-1 and free radical levels as well as a deficiency of prostacyclin. These factors may become targets for intervention as well as markers of disease progression.
Kalogeropoulou
K
K
Department of Nuclear Medicine, Army Veterans Hospital, Athens, Greece.
Mortzos
G
G
Migdalis
I
I
Velentzas
C
C
Mikhailidis
D P
DP
Georgiadis
E
E
Cordopatis
P
P
D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000473:pathology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D019332:Endothelin-1 / Q000097:blood; D011464:Epoprostenol / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology; D014463:Ultrasonography
D019332:Endothelin-1; D008315:Malondialdehyde; D011464:Epoprostenol