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Updated: May 1, 2026

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
Published on: April 27, 2016
Endothelial dysfunction in metabolic and vascular disorders
Marija M Polovina1, Tatjana S Potpara
1Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
Insights
Endothelial dysfunction links insulin resistance and type 2 diabetes mellitus (T2DM) to cardiovascular disease. Understanding these connections is key for managing metabolic and vascular health.
Area of Science:
- Cardiovascular Science
- Metabolic Science
- Endothelial Biology
Background:
- Vascular endothelium regulates cardiovascular health and metabolic homeostasis.
- Endothelial dysfunction is central to atherosclerosis and increasingly linked to insulin resistance and type 2 diabetes mellitus (T2DM).
- Metabolic disorders like T2DM are major risk factors for atherosclerosis, sharing endothelial dysfunction as a common pathway.
Purpose of the Study:
- To review the association between insulin resistance, T2DM, and endothelial dysfunction.
- To explore the underlying mechanisms linking these conditions.
- To discuss the prognostic implications and therapeutic strategies for endothelial dysfunction in metabolic and vascular disorders.
Main Methods:
- Literature review focusing on the interplay between metabolic and vascular health.
- Analysis of current research on endothelial dysfunction mechanisms.
- Synthesis of evidence on prognostic impacts and treatment options.
Main Results:
- Endothelial dysfunction is a shared background for metabolic and vascular disorders.
- It is implicated in the pathogenesis of atherosclerosis and the development of insulin resistance and T2DM.
- Evidence suggests endothelial dysfunction predicts adverse outcomes in both cardiovascular disease and insulin resistance states.
Conclusions:
- Endothelial dysfunction is a critical link between insulin resistance, T2DM, and cardiovascular disease.
- Targeting endothelial dysfunction may offer therapeutic benefits for patients with metabolic and vascular disorders.
- Further research into mechanisms and treatments is warranted.
Abstract:
Vascular endothelium has important regulatory functions in the cardiovascular system and a pivotal role in the maintenance of vascular health and metabolic homeostasis. It has long been recognized that endothelial dysfunction participates in the pathogenesis of atherosclerosis from early, preclinical lesions to advanced, thrombotic complications. In addition, endothelial dysfunction has been recently implicated in the development of insulin resistance and type 2 diabetes mellitus (T2DM). Considering that states of insulin resistance (eg, metabolic syndrome, impaired fasting glucose, impaired glucose tolerance, and T2DM) represent the most prevalent metabolic disorders and risk factors for atherosclerosis, it is of considerable scientific and clinical interest that both metabolic and vascular disorders have endothelial dysfunction as a common background. Importantly, endothelial dysfunction has been associated with adverse outcomes in patients with established cardiovascular disease, and a growing body of evidence indicates that endothelial dysfunction also imparts adverse prognosis in states of insulin resistance. In this review, we discuss the association of insulin resistance and T2DM with endothelial dysfunction and vascular disease, with a focus on the underlying mechanisms and prognostic implications of the endothelial dysfunction in metabolic and vascular disorders. We also address current therapeutic strategies for the improvement of endothelial dysfunction.
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