title: Vascular endothelial dysfunction in patients with newly diagnosed type 2 diabetes and effects of 2-year and 5-year multifactorial intervention.
abstract: OBJECTIVE
  Investigate short- and long-term effect of multifactorial intervention on endothelial dysfunction in patients with newly diagnosed type 2 diabetes.
  
  
  BACKGROUND
  Whether multifactorial intervention reduces cardiovascular risk in type 2 diabetes is largely controversial, partially because of lack of reliable method for endothelial dysfunction detection. Using high-resolution ultrasonographical flow-mediated vasodilatation (FMD), we completed a 5-year randomized prospective intervention trial in patients with newly diagnosed type 2 diabetes. We have studied the effect of multifactorial intervention therapy on their endothelial dysfunction.
  
  
  METHODS
  One hundred eight patients with newly diagnosed type 2 diabetes, and 83 healthy subjects received measurement of brachial artery FMD and endothelium-independent dilatation (EID). Diabetic patients were assigned into four groups, treated with: (A) hypoglycemic and antihypertensive agents, (B) hypoglycemic, antihypertensive and lipid-lowering agents, (C) hypoglycemic, antihypertensive and lipid-lowering agents, and vitamin E, and (D) hypoglycemic, antihypertensive and lipid-lowering agents, and compound salvia tablets. Both FMD and EID were remeasured after 24- and 60-month treatment.
  
  
  RESULTS
  FMD in diabetic patients was significantly lower than those in healthy subjects. After 24-month treatment, there was no FMD change. However, FMD improved significantly after 60-month treatment. The differences between 24- and 60-month are also significant. EID did not change significantly after both 24- and 60-month treatments.
  
  
  CONCLUSIONS
  (1) FMD-detectable endothelial dysfunction exists in newly diagnosed type 2 diabetic patients. (2) Reverse of endothelial function occurs only after long-term (60-month) multifactorial intervention. (3) FMD could potentially help early identification, stratification, and treatment of endothelial dysfunction in type 2 diabetic patients.
authors.affiliation: Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Tian
authors.forename: Yanling
authors.initials: Y
authors.lastname: Wen
authors.forename: Li
authors.initials: L
authors.lastname: Yan
authors.forename: Hua
authors.initials: H
authors.lastname: Cheng
authors.forename: Haiyun
authors.initials: H
authors.lastname: Yang
authors.forename: Jingfeng
authors.initials: J
authors.lastname: Wang
authors.forename: Hani
authors.initials: H
authors.lastname: Kozman
authors.forename: Daniel
authors.initials: D
authors.lastname: Villarreal
authors.forename: Kan
authors.initials: K
authors.lastname: Liu
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000188:drug therapy*; D058065:Diabetic Cardiomyopathies / Q000175:diagnosis* / Q000188:drug therapy*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography / Q000706:statistics & numerical data; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging*
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents