Endothelial dysfunction in a cohort of Indian patients with type-2 diabetes mellitus.

ABSTRACT

Introduction: Our aim was to study the endothelial functioning in type-2 diabetes mellitus and its correlation with factors commonly associated with type-2 diabetes mellitus like obesity and dyslipidaemia. Materials and methods: 40 patients of previously diagnosed type-2 diabetes mellitus were taken as cases and 40 matched healthy persons were taken as controls. Endothelial function was studied in both groups in accordance with the American College of Cardiology (ACC) guidelines for the ultrasound assessment of endothelial dependent flow-mediated dilation (FMD) of the brachial artery and endothelial independent flow using sublingual nitrate (GTN%). Comparisons were made and analysed statistically between the diabetics and non-diabetic matched controls. Sub-group analysis with respect to endothelial function, waist-hip ratio (WHR), body mass index (BMI), and lipid profile amongst the diabetic subjects was also made. Results: There was a statistically significant difference in the endothelial dependent dilation (4.57 ± 2.01 versus 10.38 ± 1.77 P value < 0.0001) as well as endothelial independent function (11.63 ± 2.01 versus 13.42 ± 1.92 P value 0.001) between the diabetics and non-diabetics. An inverse correlation with the endothelial function and BMI, WHR, and various parameters of the lipid profile amongst the diabetics was also demonstrated. Conclusion: Endothelial dysfunction by brachial ultrasound was found to be significantly higher in a cohort of Indian type-2 diabetics, with positive correlation with BMI and WHR as well as presence and degree of dyslipidaemia. The therapeutic and diagnostic implications of these findings need to be explored.