Impaired endothelial function is not associated with arterial stiffness in adults with type 1 diabetes

Abstract

Aim: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: AS; Aortic pulse wave velocity; Arterial stiffness; BMI; Body mass index; CHD; CV; Cardiovascular; Coronary heart disease; DBP; Diabète de type 1; Diastolic blood pressure; Dysfonction endothéliale; ED; Endothelial dysfunction; MAP; Mean arterial pressure; RH-PAT; Reactive hyperaemia peripheral arterial tonometry; Rigidité artérielle; SBP; Soluble intercellular adhesion molecule-1; Soluble vascular cell adhesion molecule-1; Systolic blood pressure; Type 1 diabetes; UAC ratio; Urinary albumin-to-creatinine ratio; WHR; Waist-to-hip ratio; aPWV; sICAM-1; sVCAM-1.