P4993Tissue sodium concentration emerged as a determinant of hypertrophic vascular remodeling in type 2 diabetes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Schmieder ◽  
S Jung ◽  
D Kannenkeril ◽  
J M Harazny ◽  
K Striepe ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Remodeling ◽  
Sodium Intake ◽  
Structural Parameters ◽  
Sodium Concentration ◽  
Sodium Content ◽  
Resistance Vessels ◽  
Retinal Arterioles ◽  
Tissue Sodium

Abstract Background Studies describe a linkage between greater sodium intake and higher incidence of organ damage and cardiovascular end points. Sodium intake is usually assessed by measuring 24-hour urinary sodium excretion, which is prone to high fluctuation. For the assessment of tissue sodium a new technique (23Na-MRI) has been developed. We analyzed whether tissue sodium is linked to vascular remodeling of small resistance vessels in patients with type-2 diabetes. Methods In patients with type 2 diabetes we assessed tissue sodium content and vascular structural parameters of the retinal arterioles, since structural changes of resistance vessels (150–300 μm) can be non-invasively and reliably assessed in the retinal circulation by Scanning Laser Doppler Flowmetry (SLDF). Patients with antidiabetic medication were off the therapy (antihypertensives were kept constant) for 4 weeks. The structural parameters of retinal arterioles assessed were outer- and inner diameter (OD & ID), wall thickness (WT), wall-to-lumen ratio (WLR) and wall cross sectional area (WCSA). Tissue sodium content was assessed non-invasively with a 3.0 T clinical MRI system in each patient. Subject placed their lower legs in the center of a 23Na knee coil and sodium content in skin and muscle (musculus triceps surae) were measured. Results In patients with type 2 diabetes (N=52) we observed a significant correlation between tissue sodium content (muscle and skin) and OD, WT and WCSA and a trend has been noticed between muscle sodium content and ID and WLR. Multiple linear regression analysis demonstrated that tissue sodium content is a significant determinant of hypertrophic vascular remodeling as indicated by increased WT and WCSA, independent of age, gender and 24-hour ambulatory diastolic blood pressure. Correlation coefficients Muscle sodium content (mmol/l) Skin sodium content (mmol/l) OD (μmol) r=0.402, p=0.003 r=0.299, p=0.033 ID (μmol) r=0.265, p=0.058 r=0.202, p=0.154 WT (μm) r=0.402, p=0.003 r=0.313, p=0.026 WLR r=0.247, p=0.078 r=0.171, p=0.230 WCSA (μm2) r=0.417, p=0.002 r=0.322, p=0.021 Conclusion With the novel 23Na-MRI technology, we could demonstrate that high tissue sodium concentration is linked to with hypertrophic vascular remodeling of retinal arterioles. Thus, the reduction of tissue sodium content may emerge as a therapeutic target.

Tissue sodium content correlates with hypertrophic vascular remodeling in type 2 diabetes

2021 ◽  
pp. 108055
Author(s):  
Dennis Kannenkeril ◽  
Susanne Jung ◽  
Harazny Joanna ◽  
Kristina Striepe ◽  
Christian Ott ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Remodeling ◽  
Sodium Content ◽  
Tissue Sodium

scholarly journals Urinary Sodium Concentration Is an Independent Predictor of All-Cause and Cardiovascular Mortality in a Type 2 Diabetes Cohort Population

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Pierre-Jean Saulnier ◽  
Elise Gand ◽  
Stéphanie Ragot ◽  
Lise Bankir ◽  
Xavier Piguel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Mortality ◽  
Independent Predictor ◽  
Sodium Intake ◽  
Sodium Concentration ◽  
Urinary Sodium ◽  
Prediction Of Mortality ◽  
Increased Risk

Objective.Sodium intake is associated with cardiovascular outcomes. However, no study has specifically reported an association between cardiovascular mortality and urinary sodium concentration (UNa). We examined the association ofUNawith mortality in a cohort of type 2 diabetes (T2D) patients.Methods. Patients were followed for all-cause death and cardiovascular death. BaselineUNawas measured from second morning spot urinary sample. We used Cox proportional hazard models to identify independent predictors of mortality. Improvement in prediction of mortality by the addition ofUNato a model including known risk factors was assessed by the relative integrated discrimination improvement (rIDI) index.Results. Participants (n=1,439) were followed for a median of 5.7 years, during which 254 cardiovascular deaths and 429 all-cause deaths were recorded.UNaindependently predicted all-cause and cardiovascular mortality. An increase of one standard deviation ofUNawas associated with a decrease of 21% of all-cause mortality and 22% of cardiovascular mortality.UNaimproved all-cause and cardiovascular mortality prediction beyond identified risk factors (rIDI = 2.8%,P=0.04and rIDI = 4.6%,P=0.02, resp.).Conclusions. In T2D,UNawas an independent predictor of mortality (low concentration is associated with increased risk) and improved modestly its prediction in addition to traditional risk factors.

Tissue sodium content in patients with type 2 diabetes mellitus

2019 ◽  
Vol 33 (7) ◽  
pp. 485-489 ◽  
Author(s):  
Dennis Kannenkeril ◽  
Marina V. Karg ◽  
Agnes Bosch ◽  
Christian Ott ◽  
Peter Linz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Sodium Content ◽  
Tissue Sodium

scholarly journals Sodium Intake and Incidence of Diabetes Complications in Elderly Patients with Type 2 Diabetes—Analysis of Data from the Japanese Elderly Diabetes Intervention Study (J-EDIT)

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 689
Author(s):  
Chika Horikawa ◽  
Rei Aida ◽  
Shiro Tanaka ◽  
Chiemi Kamada ◽  
Sachiko Tanaka ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Elderly Patients ◽  
Diabetes Complications ◽  
Vegetable Intake ◽  
Sodium Intake ◽  
Food Groups ◽  
High Sodium ◽  
Increased Risk

This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65–85. Data from 912 individuals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy (p = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31–2.41), 2.61 (1.00–6.83), and 3.70 (1.37–10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes.

Effect of Salt Supplementation on Sympathetic Activity and Endothelial Function in Salt-Sensitive Type 2 Diabetes

2019 ◽  
Vol 105 (4) ◽  
pp. e1187-e1200 ◽  
Author(s):  
Sara Baqar ◽  
Yee Wen Kong ◽  
Angela X Chen ◽  
Christopher O’Callaghan ◽  
Richard J MacIsaac ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Endothelial Function ◽  
Augmentation Index ◽  
Sodium Intake ◽  
Blood Pressure Monitoring ◽  
Muscle Sympathetic Nerve Activity ◽  
Burst Frequency ◽  
Low Sodium

Abstract Context Lower sodium intake is paradoxically associated with higher mortality in type 2 diabetes (T2D). Objective To determine whether sympathetic nervous system (SNS) activation and endothelial dysfunction contribute to these observations, we examined the effect of salt supplementation on these systems in people with T2D with habitual low sodium. We hypothesized that salt supplementation would lower SNS activity and improve endothelial function compared to placebo. Design We conducted a randomized, double-blinded, placebo-controlled crossover trial. Setting The study took place in a tertiary referral diabetes outpatient clinic. Participants Twenty-two people with T2D with habitual low sodium intake (24-hour urine sodium <150 mmol/24h) were included. Intervention Salt supplementation (100 mmol NaCl/24h) or placebo for 3 weeks was administered. Main outcome measures The primary outcome of SNS activity and endothelial function was assessed as follows: Microneurography assessed muscle sympathetic nerve activity (MSNA), pulse amplitude tonometry assessed endothelial function via reactive hyperemic index (RHI), and arterial stiffness was assessed via augmentation index (AI). Secondary outcomes included cardiac baroreflex, serum aldosterone, ambulatory blood pressure monitoring (ABPM), heart rate variability (HRV), and salt sensitivity. Results Compared to placebo, salt supplementation increased MSNA (burst frequency P = .047, burst incidence P = .016); however, RHI (P = .24), AI (P = .201), ABPM (systolic P = .09, diastolic P = .14), and HRV were unaffected. Salt supplementation improved baroreflex (slope P = .026) and lowered aldosterone (P = .004), and in salt-resistant individuals there was a trend toward improved RHI (P = .07). Conclusions In people with T2D and low habitual sodium intake, salt supplementation increased SNS activity without altering endothelial function or blood pressure but improved baroreflex function, a predictor of cardiac mortality. Salt-resistant individuals trended toward improved endothelial function with salt supplementation.

scholarly journals Parameters of cardiac hemodynamics in patients with diabetes mellitus with impairment of renal function

HYPERTENSION ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 5-10
Author(s):  
I.I. Topchiy ◽  
O.N. Kirienko ◽  
P.S. Semyonovykh ◽  
D.O. Kirienko ◽  
O.I. Tsygankov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Function ◽  
Structural Parameters ◽  
Left Ventricular ◽  
Control Group ◽  
Group I ◽  
Patients With Diabetes

Currently, diabetes mellitus (DM) is a complex global problem, which is increasing every year. So, in 2019, diabetes mellitus was detected in 463 million adults (from 20 to 79 years old) in the world. And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The study was aimed investigate the features of functional and structural changes in the heart in patients with type 2 diabetes mellitus and nephropathy. A total of 98 patients with type 2 diabetes mellitus were examined, out of which 78 patients had diabetic nephropathy (DN) of varying severity. The control group consisted of 20 healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I — patients with type 2 diabetes mellitus without signs of nephropathy (n = 36), group II — patients with type 2 diabetes mellitus with normal glomerular filtration rate (GFR) and albuminuria (n = 33), group III — patients with type 2 diabetes mellitus with decreased GFR and albuminuria (n = 29). To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique based on the recommendations of the American Echocardiographic Society. To determine indexing indicators, the patients underwent anthropometric measurements. Patients with DN and albuminuria and decreased GFR showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With DN, patients have a significant increase in left ventricular mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100 % with a decrease in GFR.

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