Role of endothelial dysfunction in the development of cardiorenal syndrome in patients with type 1 diabetes mellitus.
We examined the role of endothelial dysfunction in the development and progression of cardiorenal syndrome in 93 patients with type 1 diabetes mellitus.


METHODS
According to the stage of renal insufficiency all patients were divided into equal groups: those with normal albumin excretion rate, with microalbuminuria, with proteinuria, and with chronic renal failure. We analyzed endothelial flow-mediated dilation of the brachial artery, levels of endothelin-1, von Willerbrand factor, C-reactive protein, renal:albumin and protein excretion rates, glomerular filtration rate (GFR), and cardiovascular (ECG, echocardiography, blood pressure monitoring) functions.


RESULTS
There were negative correlations between the GFR, BP level and endothelial dysfunction markers. At the same time GFR correlated positively with the coefficient of sensitivity of endothelium to shear stress. There were also positive correlations between BP, permeability of glomerular filter and endothelial dysfunction markers and negative correlation with the coefficient of sensitivity of endothelium to shear stress and GFR. Left ventricle mass correlated with markers of endothelial dysfunction and stage of renal disease. Patients with chronic renal failure had negative correlations between LVM and GFR, ILVM and GFR and a positive correlation between ejection fraction and GFR.


CONCLUSIONS
There is a close relationship between endothelial dysfunction and development and progression of renal and cardiovascular pathology in patients with type 1 diabetes mellitus.
Shestakova
Marina V
MV
Endocrinology Research Center of the Russian Academy of Medical Sciences, ul. Dm.Ulianova 11, 117036 Moscow, Russia Federation.
Jarek-Martynowa
Iwona R
IR
Ivanishina
Natalya S
NS
Kuharenko
Svetlana S
SS
Yadrihinskaya
Maya N
MN
Aleksandrov
Andrey A
AA
Dedov
Ivan I
II
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000097:blood / Q000503:physiopathology*; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006331:Heart Diseases / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left; D016277:Ventricular Function, Left
D019332:Endothelin-1; D002097:C-Reactive Protein