The relation of HOMA index with endothelial functions determined by flow mediated dilatation method among hyperglycemic patients.

ABSTRACT

AIMS/OBJECTIVE: To research the relation between "homeostasis model assessment of insulin resistance index (HOMA-IR)" and endothelial functions, determined by the flow mediated dilatation (FMD) method with brachial artery ultrasound and the atherosclerotic factors influencing these values among hyperglycemic patients taking the same type of oral antidiabethics (sulphonylurea). METHOD: Seventy type-2 diabetes mellitus patients (33 males and 37 females, mean age 53.5 +/- 8.5 years) who took the same oral antidiabetic drugs, and 40 people (22 males, 18 females, mean age 46.9 +/- 14.6 years) as control group who had no hypertension and no cardiovascular disease were included in the study. The HOMA-IR of the patients was calculated. Patients who had HOMA-IR > or = 3.6 were assumed as insulin resistance (IR) existing and who had HOMA-IR < 3.6 were not existing. The groups were divided into the IR existing (group 1) and IR not existing (group 2). Endothelium dependent dilatation (FMD) values of the groups and the controls were calculated as percentage increase as to basic values in reactive hyperemia phase. RESULTS: FMD percentages among group 1 were significantly lower than the control group (p < 0.05). No difference was observed between group 2 and the control group (p 7gt; 0.05). Percentage increase between the basic level and reactive hyperemy phase was not found statistically significant (p > 0.05) between group 1 and 2. While the main factors influencing FMD percantages were total cholesterol, triglyceride, high-density lipoprotein, and low-density lipoprotein levels for group 1. No parameter could be found affecting the related percentages for group 2. CONCLUSION: While endothelial functions, determined by FMD method, were impaired with hyperglycemic patients whose HOMA-IR was > or = 3.6; it was normal among hyperglycemics whose HOMA-IR was < 3.6.