Association of Endothelial and Vascular Smooth Muscle Dysfunction with Cardiovascular Risk Factors, Vascular Complications, and Subclinical Carotid Atherosclerosis in Type 2 Diabetic Patients
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- Kawano Naoya
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Emoto Masanori
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Mori Katsuhito
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Yamazaki Yuko
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Urata Hiromi
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Tsuchikura Shoko
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Motoyama Koka
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Morioka Tomoaki
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Fukumoto Shinya
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Shoji Tetsuo
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Koyama Hidenori
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine. Department of Internal Medicine, Division of Endocrinology and Metabolism, Hyogo College of Medicine.
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- Okuno Yasuhisa
- Department of Geriatrics and Vascular Medicine, Osaka City University Graduate School of Medicine.
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- Nishizawa Yoshiki
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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- Inaba Masaaki
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
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Aim: Atherosclerosis and arteriosclerosis are mainly caused by the dysfunction of arterial components, namely, vascular endothelial cells, smooth muscle cells, and the extracellular matrix. Endothelial dysfunction is well established as a predictive surrogate marker of cardiovascular events; however, little is known regarding the clinical implications of vascular smooth muscle dysfunction for cardiovascular disease and microangiopathy. In the present study, we aimed to clarify the association of arterial dysfunction with micro-/macroangiopathy and conventional cardiovascular risk factors in 181 type 2 diabetic patients (T2DM; age±SD, 64±10 years; duration of diabetes, 12±10 years). <BR>Methods: Flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation (NMD) were assessed to evaluate endothelial dysfunction and vascular smooth muscle dysfunction, respectively, by using a novel ultrasound device, UNEXEF18G (Unex Co. Ltd., Japan).<BR>Results: The FMD and NMD were 6.4±3.9% and 13.4±6.6%, respectively. No significant differences in FMD were noted between T2DM with and without micro- or macroangiopathy; however, NMD in T2DM patients with micro- and macroangiopathy was significantly lower than that in T2DM patients without angiopathy. NMD decreased with the progression of chronic kidney disease (CKD) stage (p= 0.005), but not FMD (p= 0.071). On multiple regression analysis, significant independent contributors to FMD were age, smoking, systolic blood pressure, glycosylated hemoglobin, and serum total cholesterol, while those for NMD were age, systolic blood pressure, and waist circumference.<BR>Conclusion: The relationship of vascular complications and cardiovascular risk factors with NMD is different from that with FMD in type 2 diabetic patients.
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ
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Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ 19 (3), 276-284, 2012
一般社団法人 日本動脈硬化学会
