Endothelial-dependent vasodilation and incidence of type 2 diabetes in a population of healthy postmenopausal women.
OBJECTIVE
Both postmenopausal state and diabetes are associated with endothelial dysfunction and are well-known risk factors for atherosclerosis. However, the relationship of endothelium-dependent vasodilation and diabetes has never been prospectively evaluated. This study provided the opportunity to assess the association between endothelial vasodilation function and the incidence of diabetes in a cohort of apparently healthy postmenopausal women.


METHODS
We conducted a prospective cohort study that began in 1997 with 840 apparently healthy, nonobese, postmenopausal women, aged 53 +/- 6 years, initially with normal glucose tolerance at the oral glucose tolerance test. All participants were followed up for a mean period of 3.9 +/- 0.7 years (range 0.5-6.9). Endothelial function was measured as flow-mediated dilation (FMD) of the brachial artery, using high-resolution ultrasound.


RESULTS
There were no significant differences in demographic, blood pressure, and biochemical profiles among each tertile group at baseline or at follow-up review. During follow-up, 102 women developed type 2 diabetes. The adjusted relative risk (RR) for women with FMD </=4.3 (lowest tertile) was 5.87 (95% CI 4.34-8.10) versus women with FMD >/=5.6 (highest tertile reference). Each 1-unit decrease of FMD was associated with a significant 32% (22-48%) increase in the multiple-adjusted RR of incident diabetes.


CONCLUSIONS
These prospective data indicate a significant increase in the RR of diabetes with each unit decrease of FMD. This could suggest that an impaired endothelial function may play a fundamental role in diabetogenesis in postmenopausal women.
Rossi
Rosario
R
Institute of Cardiology, Policlinico Hospital University of Modena and Reggio Emilia Via del Pozzo, 71-41100 Modena, Italy. rossi.rosario@policlinico.mo.it
Cioni
Elena
E
Nuzzo
Annachiara
A
Origliani
Giorgia
G
Modena
Maria Grazia
MG
D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D001823:Body Composition; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology* / Q000503:physiopathology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004730:Endothelium, Vascular / Q000502:physiology* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012016:Reference Values; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology*
D001786:Blood Glucose