Increased plasma levels of endothelin 1 and von Willebrand factor in patients with type 2 diabetes and dyslipidemia (original) (raw)
Journal of Diabetes and its Complications, 2001
We evaluated the possible relation between plasma endothelin-1 (ET-1) levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy, including nephropathy, neuropathy, and retinopathy in patients with Type 2 diabetes and healthy control group. Sixty-eight (39 females and 29 males) patients with Type 2 diabetes and 14 (6 females and 8 males) healthy subjects were included in the study. Plasma ET-1 levels were found to be 10.46 1.24 pmol/l in the diabetic group, whereas 7.97 0.41 pmol/l in the control group, which was statistically significant ( P < .01). We also found elevated plasma ET-1 levels in patients with the least one microvascular complication when compared with the uncomplicated diabetes group ( P = .02). Moreover, plasma ET-1 levels of the uncomplicated group was higher than the control group ( P < .05). Plasma ET-1 levels were significantly elevated in hypertensive diabetics than normotensive diabetics (t = 2.58, P = .012). It was also found to be elevated in diabetic patients with diabetes duration of more than 10 years when compared with patients less than 10 years ( P = .02). These findings can be interpreted as the increased damage of microvascular complications in the disease process that may lead to elevated ET-1 levels. Mean plasma ET-1 levels in diabetic patients with a family history of diabetes was found to be higher than patients with no family history of diabetes. Genetical and environmental factors may have an effect on ET-1 level. We also studied the correlations of plasma ET-1 levels on age, sex, fasting blood glucose levels, treatment modalities HbA1c, hyperlipidemia, C-peptide, Body Mass Index, and smoking, but did not find any statistically significant difference. In conclusion, plasma ET-1 levels are well correlated with microangiopathy, hypertension, increased disease duration, and family history of diabetes, but poorly correlated with metabolic control, treatment modalities, age, sex, hyperlipidemia, obesity, and smoking. D
Elevated plasma endothelin-1 levels in diabetes mellitus
American journal of hypertension, 2002
This study compares plasma endothelin-1 (ET-1) levels in patients with diabetes mellitus or hypertension with healthy controls, and investigates whether ET-1 levels are correlated with glycemic control, metabolic parameters, and vascular complications. The study population consisted of 103 patients with type 1 diabetes, 124 patients with type 2 diabetes, 35 hypertensive patients without diabetes mellitus, and 99 controls. Plasma ET-1 concentrations were significantly higher in patients with type 1 diabetes (0.28 +/- 0.34 fmol/mL, P =.001), type 2 diabetes (0.31 +/- 0.32 fmol/mL, P <.0001), and hypertension (0.35 +/- 0.26 fmol/mL, P <.0001) compared to controls (0.08 +/- 0.13 fmol/mL). Diabetic patients taking angiotensin converting enzyme (ACE) inhibitors had significantly lower plasma ET-1 levels than patients without (0.22 +/- 0.20 fmol/mL v 0.38 +/- 0.39 fmol/mL, P =.029). There were significant associations between ET-1 levels and age (r = 0.38, P <.05) and systolic blo...
Plasma endothelin-1 levels and albuminuria in patients with type 2 diabetes mellitus
Medicinski pregled, 2016
Introduction. Microalbuminuria is a very important independent risk factor for the progression of renal diseases as well as diseases of the cardiovascular system. Pathophysiological mechanisms that lead to the development of microalbuminuria in patients with diabetes are complex and they are a result of numerous factors. In the past decade, endothelin-1, the most potent vasoconstrictor peptide, was identified as an important factor that significantly contributes to the functional and structural renal changes. The objective of this study was to investigate the relationship between plasma concentration of endothelin-1 and urinary albumin excretion in patients with type 2 diabetes mellitus. Material and Methods. There were 76 patients with type 2 diabetes who were divided into those having normoalbuminuria (n=33), microalbuminuria (n=29), and macroalbuminuria (n=14), and 30 healthy controls. Plasma levels of endothelin-1 were measured by enzyme-linked immunosorbent assay. Results. Ther...
Role of Von Willebrand Factor in Type 2 Diabetes Mellitus Patients
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Endothelial dysfunction is the main cause of morbidity and mortality in diabetic patients. Endothelial dysfunction has been incriminated in the early pathogenesis of atherosclerosis and is considered an early indicator of cardiovascular disease by dysregulation of vascular tone, growth, thrombogenicity, inflammation and the development of both micro-and macro-vascular disease states. Von Willebrand factor is a well-known marker of endothelial dysfunction. The objective of this study is to measure plasma levels of von Willebrand factor in type 2 DM patients and to compare with the normal subjects. Urinary albumin levels, which is also a marker of generalised endothelial dysfunction and a strong predictor for the development of both micro-and macro-vascular disease was also assessed in the two groups and its association with von Willebrand factor (vWF) was studied. MATERIALS AND METHODS In this cross-sectional study, twenty-five type 2 diabetic patients (45-60 years) with duration of diabetes between 5-10 years and twenty-five age and sex matched healthy volunteers were considered. Plasma von Willebrand factor (vWF) and urine albumin levels were measured, Student 't' test and Pearson correlation was used to analyse the data. RESULTS Mean levels of vWF were significantly increased (P < 0.001**) in type 2 Diabetic patients compared to normal. Mean value of urinary albumin levels was higher in those with DM compared to the normal (P < 0.001**). CONCLUSION The present study suggests that there is significant endothelial injury in type 2 DM patients and they are probably at risk of developing cardiovascular disease in the future. vWF and urinary albumin levels showed a weak correlation in type 2 DM patients, which might support the view that they are under substantially different regulatory control.
Diabetes, 2006
Endothelial dysfunction may precede development of type 2 diabetes. We tested the hypothesis that elevated levels of hemostatic markers of endothelial dysfunction, plasminogen activator inhibitor-1 (PAI-1) antigen, and von Willebrand factor (vWF) antigen predicted incident diabetes independent of other diabetes risk factors. We followed 2,924 Framingham Offspring subjects (54% women, mean age 54 years) without diabetes at baseline (defined by treatment, fasting plasma glucose >7 or 2-h postchallenge glucose >11.1 mmol/l) over 7 years for new cases of diabetes (treatment or fasting plasma glucose >7.0 mmol/ l). We used a series of regression models to estimate relative risks for diabetes per interquartile range (IQR) increase in PAI-1 (IQR 16.8 ng/ml) and vWF (IQR 66.8% of control) conditioned on baseline characteristics. Over follow-up, there were 153 new cases of diabetes. Age-and sex-adjusted relative risks of diabetes were 1.55 per IQR for PAI-1 . These effects remained after further adjustment for diabetes risk factors (including physical activity; HDL cholesterol, triglyceride, and blood pressure levels; smoking; parental history of diabetes; use of alcohol, nonsteroidal anti-inflammatory drugs, exogenous estrogen, or hypertension therapy; and impaired glucose tolerance), waist circumference, homeostasis model assessment of insulin resistance, and inflammation (assessed by levels of C-reactive protein): the adjusted relative risks were 1.18 per IQR for PAI-1 (1.01-1.37) and 1.39 for vWF (1.09 -1.77). We conclude that in this community-based sample, plasma markers of endothelial dysfunction increased risk of incident diabetes independent of other diabetes risk factors including obesity, insulin resistance, and inflammation.
American Journal of Cardiology, 2003
W e have previously shown that flow-mediated endothelium-dependent vasodilation, measured by ultrasound of the brachial artery, is impaired in healthy young men after experimental triglyceridemia 1 and in young men with persistent mild to moderate hypertriglyceridemia. 2 Similarly, other investigators showed that hypertriglyceridemia is associated with impaired pharmacologically stimulated endothelium-dependent vasodilation measured by plethysmography. These investigations indicate that hypertriglyceridemia is associated with functional impairment of the endothelium, whereas there is a paucity of studies investigating biochemical markers of endothelial activation in hypertriglyceridemia. One study showed increased plasma concentrations of soluble cell adhesion molecules together with decreased flow-mediated vasodilation. 5 Another study demonstrated that patients with severe hypertriglyceridemia have increased plasma levels of cell adhesion molecules, which were decreased by triglyceride-lowering treatment. The present report examines whether persistent mild to moderate hypertriglyceridemia in healthy young men is associated with elevated plasma concentrations of biochemical markers of inflammation and endothelial activation.
Endothelial dysfunction and serum fatty acid composition in patients with type 2 diabetes mellitus
Metabolism, 2008
The aim of this study was to evaluate the possible association between serum fatty acids composition and endothelial dysfunction in patients with type 2 diabetes mellitus. A cross-sectional study was conducted with 125 normo-or microalbuminuric type 2 diabetes mellitus patients with serum creatinine b1.5 mg/dL. Serum fatty acids composition (gas chromatography), serum levels of endothelin-1 (ET-1) (enzyme-linked immunosorbent assay), fibrinogen, serum C-reactive protein, lipids, homeostasis model assessment resistance index (HOMA-R), and 24-hour urinary albumin excretion rate were measured. Serum levels of ET-1 were positively correlated with saturated fatty acids (r = 0.257, P = .025) and negatively correlated with polyunsaturated fatty acids (PUFAs) (r = −0.319, P = .005). Serum ET-1 levels were also positively correlated with systolic blood pressure, waist circumference, total cholesterol levels, triglycerides, and HOMA-R. In multiple linear regression models, only saturated fatty acids (R 2 = 0.317, P = .002) or PUFAs (R 2 = 0.314, P = .001) remained associated with ET-1 levels. Models were adjusted for systolic blood pressure, HOMA-R, waist circumference, triglycerides, body mass index, and smoking habit. The serum total PUFA levels showed an inverse correlation with urinary albumin excretion rate (r = −0.248, P = .012). In conclusion, in type 2 diabetes mellitus patients, the serum fatty acids composition was independently related to endothelial function evaluated by serum ET-1. Saturated fatty acids were associated with endothelial dysfunction (high levels of ET-1), whereas PUFAs had a protective role in endothelial function.