title: Do patients with type 1 and type 2 diabetes really have an impaired endothelial function? A population-based propensity score matching analysis.
abstract: BACKGROUND
  Previous studies suggested an impaired endothelial function in patients with diabetes. However, the validity of this finding may be limited by the lack of adequate adjustment for further cardiovascular confounders. We assessed endothelial function as measured by flow-mediated dilation (FMD) of the brachial artery in patients with either type 1 or type 2 diabetes in comparison with non-diabetic controls.
  
  
  METHODS
  The study population comprised 1487 subjects including 122 subjects with type 2 diabetes, aged 25 to 85, from the population-based Study of Health in Pomerania, and 65 outpatients, aged 23 to 75, with type 1 diabetes. FMD measurements were performed using standardized ultrasound techniques. Subjects with type 1 and type 2 diabetes were matched 1:4 to healthy controls using propensity score matching.
  
  
  RESULTS
  Neither type 1 diabetes (β = 0.142; SE = 0.568, p = 0.803) nor type 2 diabetes (β = 0.107; SE = 0.340, p = 0.752) were significantly associated with FMD in comparison with their non-diabetic controls after adjustment for major cardiovascular confounders like age, gender, body mass index, smoking status, hypertension, antihypertensive medication, LDL and HDL cholesterol levels.
  
  
  CONCLUSIONS
  In this population-based study comparing adjusted FMD values of diabetic individuals with adequately matched controls, propensity score analyses revealed no association between diabetes and endothelial function. Since these findings are in discordance with the majority of previous reports, we suggest performing similar analyses using data from other population-based studies.
authors.affiliation: Department of Internal Medicine, Medizinische Klinik B, Universitätsmedizin, Greifswald, Sauerbruchstrasse, D-17475, Germany. empen@uni-greifswald.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Empen
authors.forename: Roberto
authors.initials: R
authors.lastname: Lorbeer
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Thorsten
authors.initials: T
authors.lastname: Reffelmann
authors.forename: Sabine
authors.initials: S
authors.lastname: Schipf
authors.forename: Matthias
authors.initials: M
authors.lastname: Nauck
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kerner
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.forename: Stephan B
authors.initials: SB
authors.lastname: Felix
authors.forename: Marcus
authors.initials: M
authors.lastname: Dörr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001916:Brachial Artery / Q000503:physiopathology*; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012039:Regional Blood Flow; D012307:Risk Factors; D014664:Vasodilation; D055815:Young Adult