P3 Factor Influencing Endothelial Function in Type 2 Diabetes Mellitus with Newly Diagnosed Hypertension

Abstract

Background

Increased risk for cardiovascular diseases is associated with diabetes, can be partially attributed to endothelial dysfunction. However, the cumulative factors leading to endothelial dysfunction in Type 2 DM are not clear. In the current study, a novel attempt was made to understand factors influencing endothelial function (EF) in humans using Angiotensin Converting Enzyme (ACE) inhibition as a tool to alter EF.

Methods

Brachial Flow-mediated-dilation (FMD) was measured using ultrasonography in 60 diabetics with newly-diagnosed hypertension. Serum E-selectin, Vascular-Cell-Adhesion-Molecule-1 (VCAM-1), hsCRP, IL-10, Renin, Ang 1–7, Ang II and ACE 2 were measured using ELISA. Amplitude of change, calculated as absolute difference in values obtained at baseline (V1) from those after 3 months (V3) (V3−V1), of biomarkers were correlated with change in FMD and E-selectin after 3 months of ACE inhibition.

Results

FMDV3-V1 showed significant negative correlation with hsCRPV3-V1, FSV3-V1, PPSV3-V1 and HbA1cV3-V1 [(r = −0.3, p = 0.02), (r = −0.31, p = 0.01), (r = −0.27, p = 0.03) (r = −0.3, p = 0.02), respectively] and significant positive correlation with Ang1–7V3-V1 (r = 0.39, p = 0.002). E-selectin correlated positively with FSV3-V1, PPSV3-V1 , HbA1cV3-V1, VCAM-1V3-V1 and ReninV3-V1 [(r = 0.35, p = 0.006), (r = 0.32, p = 0.01), (r = 0.45, p = 0.0005), (r = 0.66, p < 0.001), (r = 0.53, p < 0.0001) respectively].

Conclusion

A balance between the Renin/ Ang II and Ang 1–7/ACE2 axis plays a significant role in EF. Additionally, reduction in blood sugar levels and vascular inflammation also improves EF.