Endothelial dysfunction in type 2 diabetes mellitus subjects with peripheral artery disease

Area of Science:

• Vascular Biology
• Diabetology
• Medical Imaging

Background:

• Peripheral artery disease (PAD) is a common complication of type 2 diabetes mellitus (T2DM).
• Endothelial dysfunction is an early event in atherosclerosis and a predictor of cardiovascular events.
• High-frequency ultrasound is a valuable tool for assessing vascular function.

Observation:

• This study investigated endothelial function in T2DM patients with and without PAD, using ankle-brachial index (ABI) and high-frequency ultrasound.
• Participants included 23 T2DM patients with ABI <0.97, 31 T2DM patients with ABI ≥1.0, and 28 non-diabetic controls.
• Patients with PAD exhibited older age, longer diabetes duration, higher blood pressure, and more hypertension history.

Findings:

• Type 2 diabetic patients demonstrated impaired flow-mediated dilation (FMD) compared to non-diabetics, with further impairment in those with PAD.
• Nitroglycerin-induced dilation showed a trend towards impairment in PAD patients, but did not reach statistical significance.
• Age, baseline brachial artery diameter, ABI, and hypertension history were associated with FMD. Independent predictors of FMD, after age adjustment, were baseline diameter and ABI.

Implications:

• Endothelial dysfunction is significantly present in T2DM and exacerbated by PAD.
• ABI and baseline brachial artery diameter are key predictors of endothelial function in this population.
• These findings highlight the importance of vascular assessment in T2DM patients, particularly those with PAD.