Impaired vascular reactivity in insulin-dependent diabetes mellitus is related to disease duration and low density lipoprotein cholesterol levels

Clarkson, Patrick; Celermajer, David S.; Donald, Ann; Sampson, Mike; Sørensen, Keld E.; Adams, Mark; Yue, Dennis K.; Betteridge, D. J.; Deanfield, John

doi:10.1016/0735-1097(96)82380-1

Cited by 383 publications

(197 citation statements)

References 35 publications

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“…Sample size calculations were performed based on the FMD component of the study. In previous studies of healthy subjects, reported mean FMD values have ranged from 106% to 112% (SD 3-6.5%), while in subjects with vascular risk factors such as cigarette smoking, hypertension, or hypercholesterolemia, mean FMD ranged from 100% to 106.5% (20,36,37). For the purpose of sample size calculations we estimated a mean Ϯ SD FMD of 108 Ϯ 4% in our healthy controls.…”

Section: Methodsmentioning

confidence: 99%

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Doornum¹,

McColl²,

Jenkins³

et al. 2003

Arthritis & Rheumatism

126

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Objective. Inflammation appears to play a central role in atherosclerosis, and endothelial damage mediated by systemic inflammation may contribute to the increased cardiovascular mortality in rheumatoid arthritis (RA). Brachial artery flow-mediated dilatation (FMD) and pulse wave analysis (PWA) are measures of vascular function. The aim of this study was to determine if FMD and PWA are abnormal in patients with RA.Methods. Twenty-five RA patients and 25 matched healthy controls were studied. All were free of traditional cardiovascular risk factors. FMD was measured in all subjects. PWA was performed in 18 RA patients and 18 controls, with results expressed as large and small artery compliance (C1 and C2). Modified Sharp scores were calculated in 13 RA patients.Results. Results (mean ؎ SD) in RA patients and controls, respectively, were as follows: FMD 107.6 ؎ 4.6% versus 108.5 ؎ 4.1% (P ‫؍‬ 0.49), C1 14.8 ؎ 2.8 ml/mm Hg ؋ 10 versus 17.9 ؎ 3.1 ml/mm Hg ؋ 10 (P ‫؍‬ 0.0033), C2 4.5 ؎ 2.3 ml/mm Hg ؋ 100 versus 7.7 ؎ 3.7 ml/mm Hg ؋ 100 (P ‫؍‬ 0.0039). There was an inverse correlation between C2 and modified Sharp scores in the RA patients (Spearman's rho -0.69, P ‫؍‬ 0.0085).Conclusion. FMD was normal in these RA patients, whereas arterial compliance was markedly reduced. PWA appears to be a more sensitive measure of vascular dysfunction than FMD in RA and may be the preferred surrogate marker of vascular dysfunction in longitudinal studies of RA patients. The inverse correlation between C2 and the modified Sharp score, a measure that reflects disease activity over time, supports the notion that chronic inflammation plays a role in RA-associated atherosclerosis.

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Section: Methodsmentioning

confidence: 99%

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Doornum¹,

McColl²,

Jenkins³

et al. 2003

Arthritis & Rheumatism

126

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“…Endothelium-dependent vasodilation impaired by dietary glucose ingestion seemed to be restored by consumption of antioxidant vitamins (Levine et al, 1996;Title et al, 2000;Skyrme-Jones et al, 2000). Diabetic patients (type 1 and 2) tend to be more prone to endothelial dysfunction (eg decreased endothelium-dependent vasodilation) and to have higher levels of oxidative stress than healthy populations (Clarkson et al, 1996;Williams et al, 1996;Akkus et al, 1996;Santini et al, 1997;Ceriello et al, 1998b) and in healthy individuals postprandial hyperglycemia appears to result in increased oxidative stress (Koska et al, 1997;Ceriello et al, 1998a;Kawano et al, 1999).…”

Section: The Glycemic Index In Coronary Heart Diseasementioning

confidence: 98%

Glycemic index in chronic disease: a review

et al. 2002

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Aim: The intent of this review is to critically analyze the scientific evidence on the role of the glycemic index in chronic Western disease and to discuss the utility of the glycemic index in the prevention and management of these disease states. Background: The glycemic index ranks foods based on their postprandial blood glucose response. Hyperinsulinemia and insulin resistance, as well as their determinants (eg high energy intake, obesity, lack of physical activity) have been implicated in the etiology of diabetes, coronary heart disease and cancer. Recently, among dietary factors, carbohydrates have attracted much attention as a significant culprit, however, different types of carbohydrate produce varying glycemic and insulinemic responses. Low glycemic index foods, characterized by slowly absorbed carbohydrates, have been shown in some studies to produce beneficial effects on glucose control, hyperinsulinemia, insulin resistance, blood lipids and satiety. Method: Studies on the short and long-term metabolic effects of diets with different glycemic indices will be presented and discussed. The review will focus primarily on clinical and epidemiological data, and will briefly discuss in vitro and animal studies related to possible mechanisms by which the glycemic index may influence chronic disease.

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“…A variety of other perturbations have been reported in the coagulation systems of diabetic patients that might affect platelet function, including larger platelets, 8 greater expression of P-selectin, 14 higher platelet surface density of GP IIb/IIIa, 8,9 altered thromboxane metabolism, 15 and higher levels of circulating fibrinogen, 10 vitronectin, 16,17 and thrombin-antithrombin III complexes, 18 as well as more extensive endothelial dysfunction. 19,20 Diabetic patients also have higher mortality in the acute coronary syndromes 21 and in general have more extensive coronary artery disease than do nondiabetics. These differences may be reflected in the makeup of the target coronary arterial lesions.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus, Glycoprotein IIb/IIIa Blockade, and Heparin

Kleiman

Lincoff²,

Dj³

et al. 1998

Circulation

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Background-After angioplasty, major complications and ischemic events occur more frequently in diabetic than nondiabetic patients. To determine whether treatment with abciximab is effective in reducing these events in diabetics, we analyzed characteristics and outcomes of diabetic patients enrolled in a large multicenter study (EPILOG). Methods and Results-Of 2792 patients enrolled, 638 (23%) were diabetic. Diabetic patients were older, shorter, and heavier; more likely to be female and have three-vessel disease, prior coronary artery bypass graft surgery, a history of hypertension, or a recent myocardial infarction; and less likely to be current smokers than their nondiabetic counterparts. During hospitalization, death, myocardial infarction, or urgent revascularization occurred in 7.1% of diabetics and 7.5% of nondiabetics. By 6 months, the composite of death and myocardial infarction had occurred in 8.8% of diabetic patients and 7.4% of nondiabetics, whereas death, myocardial infarction, or revascularization had occurred in 27.2% and 22.6%, respectively. Abciximab treatment reduced death or myocardial infarction among diabetic and nondiabetic patients (hazard ratios, 0. When standard-and low-dose heparin adjuncts were compared, diabetics receiving abciximab with standard-dose heparin had marginally greater reductions in the composite of death and myocardial infarction and in target vessel revascularization than diabetics assigned to abciximab with low-dose heparin. Conclusions-Abciximab treatment in diabetic patients led to a reduction in the composite of death and myocardial infarction, which was at least as great as that seen in nondiabetic patients. However, target vessel revascularization was reduced in nondiabetic but not diabetic patients. This effect may be associated in part with lower doses of heparin. These differences may be related to differences in the platelet and coagulation systems between diabetics and nondiabetics, the greater extent of coronary artery disease in diabetics, or patient selection and management factors. (Circulation. 1998;97:1912-1920.)

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Impaired vascular reactivity in insulin-dependent diabetes mellitus is related to disease duration and low density lipoprotein cholesterol levels

Cited by 383 publications

References 35 publications

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Glycemic index in chronic disease: a review

Diabetes Mellitus, Glycoprotein IIb/IIIa Blockade, and Heparin

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