serval:BIB_47F27DC83494
Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes.
19337558
Beer
S.
author
Feihl
F.
author
Ruiz
J.
author
Juhan-Vague
I.
author
Aillaud
M.F.
author
Wetzel
S.G.
author
Liaudet
L.
author
Gaillard
R.C.
author
Waeber
B.
author
article
2008
Vascular Health and Risk Management
1178-2048
journal
4
6
1449-1458
AIM: Patients with non-insulin-dependent diabetes mellitus (NIDDM) are at increased cardiovascular risk due to an accelerated atherosclerotic process. The present study aimed to compare skin microvascular function, pulse wave velocity (PWV), and a variety of hemostatic markers of endothelium injury [von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA), tissue factor pathway inhibitor (TFPI), and the soluble form of thrombomodulin (s-TM)] in patients with NIDDM. METHODS: 54 patients with NIDDM and 38 sex- and age-matched controls were studied. 27 diabetics had no overt micro- and/or macrovascular complications, while the remainder had either or both. The forearm skin blood flow was assessed by laser-Doppler imaging, which allowed the measurement of the response to iontophoretically applied acetylcholine (endothelium-dependent vasodilation) and sodium nitroprusside (endothelium-independent vasodilation), as well as the reactive hyperemia triggered by the transient occlusion of the circulation. RESULTS: Both endothelial and non-endothelial reactivity were significantly blunted in diabetics, regardless of the presence or the absence of vascular complications. Plasma vWF, TFPI and s-TM levels were significantly increased compared with controls only in patients exhibiting vascular complications. Concentrations of t-PA and PAI-1 were significantly increased in the two groups of diabetics versus controls. CONCLUSION: In NIDDM, both endothelium-dependent and -independent microvascular skin reactivity are impaired, whether or not underlying vascular complications exist. It also appears that microvascular endothelial dysfunction is not necessarily associated in NIDDM with increased circulating levels of hemostatic markers of endothelial damage known to reflect a hypercoagulable state.
Administration, Cutaneous
Aged
Biological Markers
Blood Flow Velocity
Case-Control Studies
Diabetes Mellitus, Type 2
Diabetic Angiopathies
Endothelium, Vascular
Female
Forearm
Hemostasis
Hot Temperature
Humans
Hyperemia
Iontophoresis
Laser-Doppler Flowmetry
Male
Microcirculation
Middle Aged
Pulsatile Flow
Regional Blood Flow
Skin
Vasodilation
Vasodilator Agents
eng
60_published
University of Lausanne
mailto:serval_help@unil.ch
http://www.unil.ch/serval
http://serval.unil.ch/disclaimer
https://serval.unil.ch/notice/serval:BIB_47F27DC83494