Vascular function and carotid intimal-medial thickness in children with insulin-dependent diabetes mellitus

Abstract

Endothelial function is impaired in children with diabetes mellitus within the first decade of its onset and precedes an increase in carotid IMT. The relative timing of these events is important in the evaluation of strategies to prevent progression of atherosclerosis and other vascular complications in this patient population.

Determinants of Arterial Nitrate-Mediated Dilatation in Children

“…Methods and Results-Brachial artery flow-mediated endothelium-dependent dilatation (FMD) Key Words: arteries Ⅲ diabetes mellitus Ⅲ endothelium Ⅲ nitroglycerin Ⅲ pediatrics E ndothelial dysfunction is currently considered a key early event in the atherosclerotic process already evident in children with cardiovascular risk factors, such as hypercholesterolemia 1 and diabetes. 2 The brachial artery ultrasound test for flow-mediated endothelial-dependent vasodilatory function (FMD), described by Celermajer et al, 1 includes administration of sublingual nitrates to examine the vasodilating effect of an exogenous source of nitric oxide (NO). NO acts directly at the level of the arterial smooth muscle cells and produces an endothelium-independent dilatation response.…”

“…2 The brachial artery ultrasound test for flow-mediated endothelial-dependent vasodilatory function (FMD), described by Celermajer et al, 1 includes administration of sublingual nitrates to examine the vasodilating effect of an exogenous source of nitric oxide (NO). NO acts directly at the level of the arterial smooth muscle cells and produces an endothelium-independent dilatation response.…”

“…3 In most previous studies in children, the NMD responses have actually been mildly reduced in high-risk individuals, although the difference has not reached statistical significance, possibly because of limited sample size. 1,2,5 Increased oxidative stress and oxidized LDL have been implicated as risk factors for atherosclerosis 6 and shown to potently quench NO 7 and decrease its production 8 in experimental studies. Recent studies have associated oxidative stress with nitrate tolerance.…”

Impact of Lifestyle-Related Diseases on Carotid Arterial Wall Elasticity as Evaluated by an Ultrasonic Phased-Tracking Method in Japanese Subjects

“…In early atherosclerotic lesions, impaired local availability of nitric oxide and endothelium-dependent vasodilatation may result from either short-or long-term exposure to several risk factors. Recurrent or persistent exposure to the risk factors may result in a state of persistent endothelial dysfunction and altered vascular wall milieu that might promote progression of the structural changes associated with atherosclerosis 28) . These changes are proposed as one possible explanation for the increases in elastic modulus values in association with various risk factors in the group with max IMT 1.1 mm observed in this study.…”

The Assessment of Atherosclerosis in Erectile Dysfunction Subjects Using Photoplethysmography

“…Also, impaired endothelial function preceding atherosclerotic changes has been observed [29]. As the measurement of the intima-media thickness of the carotid arteries is considered a surrogate marker of subclinical atherosclerosis, this method has been used widely in these patients to asses vascular health [28].…”