Irrespective to glycemic control postprandial hypertriglyceridemia induces more endothelial dysfunction in type 2 diabetes mellitus

ABSTRACT

Endothelium-dependent vasodilation was studied noninvasively in the brachial artery during fasting normolipidemic and physiological postprandial triglyceridemic states. The study was carried out on type 2 diabetics and healthy controls. The effect of both actual [FBS and 2hPPBS] and midterm [HbAlc] glycemic control was evaluated too. 14 controlled diabetics. 16 uncontrolled diabetics, and 15 healthy controls were recruited in the research. The patients had no diabetic complications. Both controlled and uncontrolled diabetic groups had matched age [43.3 +/- 11.2, 40.83 +/- 13.5 Vs 41.63 +/- 12.3] and sex [M/F 8.6, 8/8 Vs 8/7] with the control group. Beside the basic investigations, basal serum insulin and fasting lipid profile as well as 4-5 hours postprandial serum triglycerides levels, were esdtimated. Using high-resolution ultrasound, we measured the endotheliam-dependent vasodilation [FAD%] and the blood flow velocity [TAVx] at rest and postocclusive during fasting normolipidemic and 4-5 hours after a fatty meal [serum triglycerides level exceeds 350 mg/dl]. The blood flow velocity cm/sec at rest "TAVx rest"; both on fasting [9.0 +/- 0.2. 11.0 +/- 0.34 Vs 10.6 +/- 0.65] and postabsorptive hypertriglyceridemia [11.0 +/- 0.29, 12.0 +/- 0.29, 12.0 +/0.54 Vs 10.9 +/- 0.72] showed no significant difference between the controlled and uncontrolled diabetic subjects and the healthy controls, when compared to each other [P>0.1]. We found an increase in TAVx postocclustive during the fasting [28.04 +/- 1.05, 29.03 +/- 1.08 Vs 38.9 +/- 2.09 cm/sec.] as well as the significantly higher in the control subjects compared with both diabetic groups. FAD% 'fassting" [7.3 +/- 0.03, 8.02 +/- 0.09 Vs 11.4 +/- 1.07] of both diabetic groups was lower than that of the control group [P<0.01]. However, there was no significant difference between the two diabetic groups [P>0.1]. Agvain, a further reduction of FAD% "postabsorptive" [5.6 +/- 0.02, 5.1 +/- 0.01 Vs 10.4 +/- 10.04], was obtained in both diabetic groups, compared with the control group. Moreover, FAD% "postabsorptive" of each diabetic group was markedly reduced, when compared with its own fad% "fasting" value [p < 0.001], ety, there was no significant difference between the two diabetic groups regarding FAD% "fasting" as mentioned before- or FAD% "postabsorptive" [P > 0.1]. Regarding. FAD% of the healthy controls; there was no statistically significant difference between that of "fasting" and "postabsorptive"