Impaired serum capacity to induce cholesterol efflux is associated with endothelial dysfunction in type 2 diabetes mellitus.
OBJECTIVE
Reverse cholesterol transport (RCT) plays a protective role against atherosclerosis and cholesterol efflux from cells is an early step in the RCT pathway. We investigated whether the capacity of serum to induce cholesterol efflux was associated with endothelial dysfunction in type 2 diabetes.


METHODS
Endothelium-dependent and -independent vasodilation of the brachial artery was measured by high-resolution vascular ultrasound and serum cholesterol efflux capacity was determined by measuring the transfer of [3H]cholesterol from Fu5AH cells to serum in 137 patients with type 2 diabetes and 75 controls.


RESULTS
Serum cholesterol efflux capacity was lower in diabetic patients than in the controls (13.6+/-2.5% vs. 14.6+/-3.4%, respectively, p=0.02), and both endothelium-dependent vasodilation (4.9+/-2.2% vs. 8.8+/-4.1%, respectively, p<0.01) and endothelium-independent vasodilation were impaired (13.4+/-4.3% vs. 16.3+/-5.5%. respectively, p<0.01). Endothelium-dependent vasodilation correlated with serum cholesterol efflux capacity (r=0.26, p=0.003) in diabetic patients and controls (r=0.24, p=0.037). On general linear model analysis, the presence of diabetes, brachial artery diameter and serum cholesterol efflux capacity were significant independent determinants of endothelium-dependent vasodilation.


CONCLUSIONS
Impaired serum cholesterol efflux capacity was associated with endothelial dysfunction independent of other cardiovascular risk factors.
Zhou
Huali
H
Department of Endocrinology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
Shiu
Sammy W M
SW
Wong
Ying
Y
Tan
Kathryn C B
KC
D000328:Adult; D000818:Animals; D001692:Biological Transport; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006528:Carcinoma, Hepatocellular / Q000378:metabolism; D016022:Case-Control Studies; D045744:Cell Line, Tumor; D002784:Cholesterol / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008113:Liver Neoplasms / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D051381:Rats; D014463:Ultrasonography; D014664:Vasodilation
D015415:Biomarkers; D002784:Cholesterol