Department of Diabetes, Endocrinology and Nutrition, Hospital of Sabadell, Corporació Sanitària i Universitària Parc Taulí (Universitat Autònoma de Barcelona), 08208 Sabadell, Spain.
Diabetes Metab. 2013 Sep;39(4):355-62. doi: 10.1016/j.diabet.2013.03.006. Epub 2013 May 3.
This study investigated the relationship between endothelial dysfunction (ED) and arterial stiffness (AS) in adults with type 1 diabetes and no clinical cardiovascular (CV) disease.
A total of 68 patients with type 1 diabetes and 68 age- and gender-matched healthy (non-diabetic) subjects were evaluated. ED was assessed by reactive hyperaemia peripheral arterial tonometry (RH-PAT) and by serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin. AS was assessed by aortic pulse wave velocity (aPWV). All statistical analyses were stratified by gender.
Adults with type 1 diabetes had RH-PAT index scores similar to those of their matching controls [men: 1.55 (1.38-1.98)% versus 1.61 (1.40-2.17)%, P=0.556; women: 2.07 (1.55-2.31)% versus 2.08 (1.79-2.49)%; P=0.215]. However, after adjusting for potential confounders, type 1 diabetes emerged as the main determinant of the RH-PAT index in women. Also, differences between genders in both the controls and type 1 diabetes patients disappeared. Men with diabetes had higher serum concentrations of E-selectin, and women had higher serum concentrations of sICAM-1, sVCAM-1 and E-selectin than their respective controls. However, after adjusting for potential confounders, only the differences in sICAM-1 (women) and E-selectin (both genders) remained significant. No association was found between aPWV and the RH-PAT index and ED markers after adjusting for CV risk factors.
ED was increased in adults with type 1 diabetes compared with age-matched non-diabetic subjects. Also, gender differences in ED were lost in type 1 diabetes. However, ED was not associated with AS after adjusting for potential confounders. These findings suggest that ED occurs earlier than AS in type 1 diabetes.
本研究旨在探讨 1 型糖尿病且无临床心血管疾病的成年人中内皮功能障碍（ED）与动脉僵硬度（AS）之间的关系。
共评估了 68 例 1 型糖尿病患者和 68 名年龄和性别匹配的健康（非糖尿病）对照者。通过反应性充血外周动脉张力测定法（RH-PAT）和血清可溶性细胞间黏附分子-1（sICAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1）和 E-选择素浓度评估 ED。通过主动脉脉搏波速度（aPWV）评估 AS。所有统计分析均按性别分层。
1 型糖尿病患者的 RH-PAT 指数评分与匹配对照组相似[男性：1.55（1.38-1.98）%与 1.61（1.40-2.17）%，P=0.556；女性：2.07（1.55-2.31）%与 2.08（1.79-2.49）%；P=0.215]。然而，在校正潜在混杂因素后，1 型糖尿病成为女性 RH-PAT 指数的主要决定因素。此外，对照组和 1 型糖尿病患者的性别差异也消失了。糖尿病男性的血清 E-选择素浓度较高，而女性的血清 sICAM-1、sVCAM-1 和 E-选择素浓度高于各自的对照组。然而，在校正潜在混杂因素后，只有 sICAM-1（女性）和 E-选择素（两性）的差异仍具有显著性。校正心血管危险因素后，aPWV 与 RH-PAT 指数和 ED 标志物之间无相关性。
与年龄匹配的非糖尿病患者相比，1 型糖尿病患者的 ED 增加。此外，1 型糖尿病患者的 ED 性别差异消失。然而，校正潜在混杂因素后，ED 与 AS 无关。这些发现表明，在 1 型糖尿病中，ED 发生早于 AS。
