Correlations between endothelial function in the systemic and cerebral circulation and insulin resistance in type 2 diabetes mellitus

Abstract

Insulin resistance is associated with endothelial dysfunction in type 2 diabetes mellitus, which can lead to impaired vascular reactivities of both systemic and cerebral circulations. Appropriate 'correction' of vascular reactivity results for non-endothelium-dependent systemic effects avoids misinterpretation of endothelial function. Therefore, we 'corrected' vascular reactivity results and explored the potential correlations between systemic vascular reactivity, cerebrovascular reactivity and insulin resistance. In 34 patients, 'systemic vascular reactivity' was assessed by quantifying reactive hyperaemia. Cerebrovascular reactivity was assessed by quantifying changes in cerebral blood flow velocity during hypercapnia. To minimize the influence of non-endothelium-dependent systemic effects on vascular reactivity results, 'corrected systemic vascular reactivity' was calculated by normalizing systemic vascular reactivity using the measurements from the contralateral side; and cerebrovascular reactivity results were corrected by calculating percentage and absolute changes in cerebrovascular conductance index ('percent cerebrovascular conductance index' and 'delta cerebrovascular conductance index', respectively). Insulin resistance was estimated by homeostatic model assessment. Correlation between conventional cerebrovascular reactivity and systemic vascular reactivity was not significant. But correlations between 'corrected systemic vascular reactivity' and 'percent cerebrovascular conductance index' (r = 0.51; p = 0.002) and 'corrected systemic vascular reactivity' and 'delta cerebrovascular conductance index' (r = 0.50; p = 0.003) were significant. Among all vascular reactivity parameters, only 'delta cerebrovascular conductance index' was significantly correlated with homeostatic model assessment of insulin resistance (r = −0.38; p = 0.029). In conclusion, endothelial function in the systemic and cerebral circulations is moderately correlated, provided that vascular reactivity estimates are corrected for non-endothelium-dependent influences.

Improvement of vascular dysfunction by argirein through inhibiting endothelial cell apoptosis associated with ET-1/Nox4 signal pathway in diabetic rats

“…Type 2 diabetes mellitus (T2DM) affects a rapidly growing portion of the global population and is prone to an array of vascular complications 1 . Abnormal endothelial function is considered as early critical event in atherogenesis to contribute to clinical vascular lesion in diabetes 2 . Endothelial cell apoptosis may increase smooth muscle cell proliferation and migration, enhance blood coagulation and increase leukocyte infiltration into the endothelium thus leading to endothelial dysfunction 3 .…”

Insulin resistance may affect the functional recovery of acute ischemic stroke in non-diabetic patients

“…Endothelial function is related to vascular reactivity in the cerebral circulation. [16] Insulin and insulin resistance affect the vascular endothelium. [16][17][18] Furthermore, insulin resistance is a risk factor for atherosclerosis.…”

“…[16] Insulin and insulin resistance affect the vascular endothelium. [16][17][18] Furthermore, insulin resistance is a risk factor for atherosclerosis. [19,20] Endothelial dysfunction, decreased vascular reactivity, and enhanced atherosclerosis might cause recurrent stroke and delayed restoration.…”

Visualization of skin microvascular dysfunction of type 1 diabetic mice using in vivo skin optical clearing method

“…However, the ex vivo great vessels might not be consistent with the microvessels in the same reactivity test. Some in vivo studies only focused on comparing skin blood vessel function between diabetes and normal physiological state, 15,16,[51][52][53][54] but little attention has been paid to changes in vascular dysfunction along the development of diabetes. Krumholz et al 13 employed the functional photoacoustic microscopy to measure blood flow and oxygen level of mouse ear blood vessels with the development of diabetes in a resting state.…”

“…Researchers employed various reactivity tests to assess the skin vascular functional response under diabetic condition, 10,15,16 in which the pharmacological interventions such as acetylcholine, sodium nitroprusside, and noradrenaline (NE) were applied. 8,10 Some noninvasive in vivo optical imaging techniques have been proposed to monitor microvascular reactivity tests, 17 including laser Doppler technique, 18 photoacoustic imaging, 13 laser speckle contrast imaging (LSCI), 19 hyperspectral imaging (HSI), etc.…”