Evaluation of endothelial dysfunction in patients with type 2 diabetes mellitus Analysis of 100 cases

Abstract

Background: Atherosclerosis which is a precursor for macro-vascular disease involves both functional as well as structural changes in the vasculature. Functional changes involve abnormalities in endothelium, vascular smooth muscle cells and platelet functions. Endothelial dysfunction was reported in type 2 DM cases. Ultrasound assessment of brachial artery FMD (Flow Mediated Dilatation) provides important information about vascular function in health and disease. Low FMD values predict independently an established atherosclerosis. Materials and methods: A total of 150 individuals included in this study; 100 were diabetes mellitus patients and 50 were age matched persons without diabetes, hypertension or vascular disease. Of 100 diabetes patients 50 each were grouped in two groups with good (HbA1c 7.5%) and poor (HbA1C >7.5%) control of hyperglycemia. Brachial artery flow mediated vasodilatation (FMD) was studied in all patient after overnight fasting (8 hours) using 7.5 MHz phased array transducer. The medial epicondyle was used as anatomical landmark for brachial artery. Observations : In this study it is observed that, the mean age for FMD 4.5% is 59.7011.08 and FMD >4.5% is 56.538.37. Age is higher in diabetics with FMD % 4.5. Females who FMD 4.5% were 50.0% and 42.5% with FMD >4.5%. Smoking in diabetics with FMD 4.5% was 10.0% and FMD >4.5 % was 15%. Hypertension was equally found 40%. Family history of diabetes with FMD % 4.5 was 30% and FMD >4.5% were none. Summary and conclusions : The data suggest that endothelial function is a useful prognostic marker in coronary artery disease patients. In these patients, it has been reported that endothelial dysfunction is an independent prognostic factor and may predict future events, irrespective of the angiographic severity of the disease. Moreover, blunted endothelial function may reflect early atherosclerosis, and should lead to a detailed evaluation.