Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes

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...

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Autores principales: Beer, Sandra, Feihl, François, Ruiz, Juan, Juhan-Vague, Irène, Aillaud, Marie-Françoise, Wetzel, Sandrine Golay, Liaudet, Lucas, Gaillard, Rolf C, Waeber, Bernard
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2008
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663449/
https://www.ncbi.nlm.nih.gov/pubmed/19337558
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author Beer, Sandra
Feihl, François
Ruiz, Juan
Juhan-Vague, Irène
Aillaud, Marie-Françoise
Wetzel, Sandrine Golay
Liaudet, Lucas
Gaillard, Rolf C
Waeber, Bernard
author_facet Beer, Sandra
Feihl, François
Ruiz, Juan
Juhan-Vague, Irène
Aillaud, Marie-Françoise
Wetzel, Sandrine Golay
Liaudet, Lucas
Gaillard, Rolf C
Waeber, Bernard
author_sort Beer, Sandra
collection PubMed
description 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.
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spelling pubmed-26634492009-04-01 Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes Beer, Sandra Feihl, François Ruiz, Juan Juhan-Vague, Irène Aillaud, Marie-Françoise Wetzel, Sandrine Golay Liaudet, Lucas Gaillard, Rolf C Waeber, Bernard Vasc Health Risk Manag Original Research 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. Dove Medical Press 2008-12 /pmc/articles/PMC2663449/ /pubmed/19337558 Text en © 2008 Dove Medical Press Limited. All rights reserved
spellingShingle Original Research
Beer, Sandra
Feihl, François
Ruiz, Juan
Juhan-Vague, Irène
Aillaud, Marie-Françoise
Wetzel, Sandrine Golay
Liaudet, Lucas
Gaillard, Rolf C
Waeber, Bernard
Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes
title Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes
title_full Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes
title_fullStr Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes
title_full_unstemmed Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes
title_short Comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes
title_sort comparison of skin microvascular reactivity with hemostatic markers of endothelial dysfunction and damage in type 2 diabetes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663449/
https://www.ncbi.nlm.nih.gov/pubmed/19337558
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