Early endothelial dysfunction in young type 1 diabetics.
OBJECTIVE
Endothelial dysfunction is a known precursor of atherosclerosis and can be assessed by measuring the brachial artery flow-mediated dilatation (FMD) via ultrasonography. This study investigated endothelial function in young type 1 diabetics without cardiovascular morbidity or diabetes-related pathology.


METHODS
Young diabetics and healthy controls were recruited, both meeting strict inclusion and exclusion criteria. To prove absence of subclinical atherosclerosis, intima-media thickness (IMT) measurements at the carotid bifurcation were done in all of them. FMD was measured at the brachial artery. The results were compared using the t-test and the influences of different variables on FMD were assessed using multiple linear regression.


RESULTS
Twenty-six diabetics (23.4+/-5.8 years) and 36 healthy volunteers (23.1+/-2.8 years) were recruited. The duration of diabetes was 9.2+/-5.3 years; metabolic control was moderate (HbA1c 7.6+/-1.0%) and IMT was normal in both groups. FMD was significantly impaired in type 1 diabetics (7.13+/-0.43 vs. 8.77+/-0.43%; p=0.002). The FMD grade was associated with diabetes and age. Patients with a good metabolic control (HbA1c</=7.0%) had a better FMD.


CONCLUSIONS
In type 1 diabetics, even without preclinical or clinical atherosclerosis, endothelial function is already disturbed and can be detected using ultrasonography.
Hurks
R
R
Department of Vascular Surgery, Antwerp University Hospital, Wilrijkstraat 10, B 2650 Edegem, Belgium.
Eisinger
M J
MJ
Goovaerts
I
I
van Gaal
L
L
Vrints
C
C
Weyler
J
J
Hendriks
J
J
van Schil
P
P
Lauwers
P
P
D000293:Adolescent; D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D001530:Belgium / Q000453:epidemiology; D001783:Blood Flow Velocity / Q000502:physiology; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology*; D055815:Young Adult