[Effect of metabolic factors on the vasorelaxation endothelial function in patients with type II diabetes and arterial hypertension].

The aim of the study was to evaluate the functional condition of the endothelium in patients with type II diabetes and arterial hypertension, depending on various metabolic factors. 85 patients aged 54.69 +/- 7.08 years were under dynamic observation. The patients had had diabetes and arterial hypertension (AH) for 5.99 +/- 4.37 and 8.65 +/- 5.52 years, respectively. The average HbAlc level was 7.91 +/- 1.73 mmol/ 1, total cholesterol level--6.35 +/- 1.81 mmol/l, body weight index--32.98 +/- 5.14 kg/m2. The average systolic and diastolic blood pressure levels were 162 +/- 7.6 and 97 +/- 3.4 mmHg, respectively. Carbohydrate and lipid exchange parameters, the extent of hyperinsulinemia and insulin resistance, and lipid peroxidation activity were evaluated. The functional condition of the endothelium was evaluated by D. Celermajer non-invasive measurement of flow-induced endothelium-dependent vasodilatation (EDVD) of the brachial artery (BA) using high-resolution ultrasound. 87% of the patients with type II diabetes and AH had endothelial dysfunction (ED), revealed by reactive hyperemia test; 30% of the patients had significant disorder of vasoreactivity (no BA artery diameter increase, but paradoxical vasoconstriction in response to reactive hyperemia). The presence and length of endothelial dysfunction (ED) in the patients with type II diabetes and AH depended on the length of diabetes, the length and extent of AH, and presence of long-term macro- and microvascular complications (coronary heart disease, diabetic retino- and nephropathy). The study did not found any dependence of the vasorelaxing endothelial function on glycosylated hemoglobin level, atherogenic blood lipid spectrum fractions, or lipid peroxidation activity. EDVD positively correlated with ApoA-1 protein level, reflecting the antiatherogenic potential of blood lipid spectrum.