1. Microalbuminuria is associated with impaired arterial and venous endothelium-dependent vasodilation in patients with Type 2 diabetes.
- Author
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Silva AM, Schaan BD, Signori LU, Plentz RD, Moreno H Jr, Bertoluci MC, and Irigoyen MC
- Subjects
- Adult, Aged, Albuminuria epidemiology, Albuminuria physiopathology, Brachial Artery diagnostic imaging, Brachial Artery physiopathology, Diabetes Mellitus, Type 2 epidemiology, Diabetic Angiopathies diagnosis, Diabetic Angiopathies epidemiology, Diabetic Angiopathies physiopathology, Diagnostic Techniques, Cardiovascular, Female, Hand blood supply, Humans, Male, Middle Aged, Regional Blood Flow, Ultrasonography, Vasodilation physiology, Veins physiopathology, Albuminuria complications, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 physiopathology, Diabetic Angiopathies complications, Endothelium, Vascular physiopathology
- Abstract
Background: Microalbuminuria in Type 2 diabetes is associated with arterial endothelial dysfunction, but the venous bed was never evaluated., Aim: To study the endothelial function in the venous and arterial bed in patients with Type 2 diabetes with normoalbuminuria or microalbuminuria., Material and Methods: We evaluated 28 patients with Type 2 diabetes, glycated hemoglobin (HbA(₁c)) <7.5%, who were classified as normo- (albuminuria <30 mg/24 h; no.=16) or microalbuminuric (albuminuria 30-300 mg/24 h; no.=12). Venous and arterial endothelial function were assessed by the dorsal hand vein technique (venodilation by acetylcholine) and brachial artery flow-mediated vasodilation, respectively., Results: Patients were normotensive (systolic arterial pressure: 131.1±10.6 mmHg) and on good metabolic control (HbA(₁c): 6.6±0.6%). Microalbuminuric patients presented impaired venous (32.9±17.4 vs 59.3±26.5%; p=0.004) and arterial vasodilation (1.8±0.9 vs 5.1±2.4; p<0.001), as compared to normoalbuminuric patients. There was a negative correlation between acetylcholine-induced venodilation and albuminuria (r=-0.62; p<0.001) and HbA(₁c) (r=-0.41; p=0.032). The same was observed between flow mediated arterial vasodilation and albuminuria (r=-0.49; p=0.007) and HbA(₁c) (r=-0.44; p=0.019). Venous and arterial vasodilation was positively correlated (r=0.50; p=0.007)., Conclusions: Both venous and arterial endothelial function are impaired in Type 2 microalbuminuric diabetics, in spite of good metabolic control, suggesting that other factors are involved in its pathogenesis.
- Published
- 2010
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