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- Title
Metabolic Factors Predict Changes in Endothelial Function During the Early Course of Type 1 and Type 2 Diabetes.
- Authors
Zaharia, Oana Patricia; Schön, Martin; Löffler, Luca; Strassburger, Klaus; Möser, Clara; Yurchenko, Iryna; Bódis, Kálmán; Antoniou, Sofia; Karusheva, Yanislava; Szendroedi, Julia; Burkart, Volker; Roden, Michael
- Abstract
Context: Endothelial dysfunction may occur early in the development of cardiovascular and metabolic diseases; however, it remains often underestimated and studies rarely discriminate between diabetes types. We have examined endothelial function and its determinants during the early course of type 1 and type 2 diabetes. Methods: Caucasian participants of the prospective German Diabetes Study (GDS) with known diabetes duration <1 year (n = 398) or without diabetes, but of similar age, body mass index (BMI) and sex distribution (n = 109), underwent measurements of flow-mediated dilation (FMD) and nitroglycerin-mediated dilatation (NMD). Whole-body insulin sensitivity (M-value) was assessed by hyperinsulinemic-euglycemic clamps and physical fitness (VO2max) by spiroergometry. A subset of individuals with type 1 or type 2 diabetes (n = 108) was re-evaluated after 5 years. Results: At baseline, neither FMD nor NMD differed between people with diabetes and the matched glucose-tolerant groups. At the 5-year follow-up, decline in FMD (-13.9%, P = .013) of persons with type 2 diabetes was independent of age, sex, and BMI, but associated with baseline adipose tissue insulin resistance and indices of liver fibrosis. The M-value decreased in both type 1 and type 2 diabetes groups by 24% and 15% (both P < .001, respectively) over 5 years. Higher HbA1c, lower M-value, and lower VO2max at baseline was associated with lower FMD in both type 1 and type 2 diabetes. Conclusion: Endothelial function decreases during the early course of type 2 diabetes. In addition to age and BMI, insulin sensitivity at diagnosis was the best predictor of progressive impairment in endothelial function in type 2 diabetes.
- Subjects
ENDOTHELIUM diseases; TYPE 2 diabetes; DILATATION &; curettage; INSULIN resistance; NITROGLYCERIN
- Publication
Journal of Clinical Endocrinology & Metabolism, 2022, Vol 107, Issue 10, pe4167
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/clinem/dgac480