Coronary circulatory dysfunction in insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus

Details

Serval ID
serval:BIB_1DB34D4DC778
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Coronary circulatory dysfunction in insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus
Journal
Circulation
Author(s)
Prior  J. O., Quinones  M. J., Hernandez-Pampaloni  M., Facta  A. D., Schindler  T. H., Sayre  J. W., Hsueh  W. A., Schelbert  H. R.
ISSN
1524-4539
Publication state
Published
Issued date
05/2005
Peer-reviewed
Oui
Volume
111
Number
18
Pages
2291-8
Notes
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S. --- Old month value: May 10
Abstract
BACKGROUND: Abnormal coronary endothelial reactivity has been demonstrated in diabetes and is associated with an increased rate of cardiovascular events. Our objectives were to investigate the presence of functional coronary circulatory abnormalities over the full spectrum of insulin resistance and to determine whether these would differ in severity with more advanced states of insulin resistance. METHODS AND RESULTS: Myocardial blood flow (MBF) was measured with positron emission tomography and 13N-ammonia to characterize coronary circulatory function in states of insulin resistance without carbohydrate intolerance (IR), impaired glucose tolerance (IGT), and normotensive and hypertensive type 2 diabetes mellitus (DM) compared with insulin-sensitive (IS) individuals. Indices of coronary function were total vasodilator capacity (mostly vascular smooth muscle-mediated) during pharmacological vasodilation and the nitric oxide-mediated, endothelium-dependent vasomotion in response to cold pressor testing. Total vasodilator capacity was similar in normoglycemic individuals (IS, IR, and IGT), whereas it was significantly decreased in normotensive (-17%) and hypertensive (-34%) DM patients. Compared with IS, endothelium-dependent coronary vasomotion was significantly diminished in IR (-56%), as well as in IGT and normotensive and hypertensive diabetic patients (-85%, -91%, and -120%, respectively). CONCLUSIONS: Progressively worsening functional coronary circulatory abnormalities of nitric oxide-mediated, endothelium-dependent vasomotion occur with increasing severity of insulin-resistance and carbohydrate intolerance. Attenuated total vasodilator capacity accompanies the more clinically evident metabolic abnormalities in diabetes.
Keywords
Adult Blood Flow Velocity *Coronary Circulation Diabetes Mellitus, Type 2/*physiopathology Diabetic Angiopathies Endothelium, Vascular/physiopathology Female Glucose Intolerance/*physiopathology Humans Hypertension *Insulin Resistance Male Mexican Americans Middle Aged Nitric Oxide/pharmacology Vasodilation/drug effects
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2008 16:38
Last modification date
20/08/2019 12:54
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