PS 17-18 DYNAMICS OF PARAMETERS OF ENDOTHELIAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES ACCORDING TO FLOW-MEDIATED DILATION DURING THE CPAP-THERAPY

Background: Cardiovascular diseases (CVD) are the major cause of mortality in type 2 diabetes patients (T2DM). The causes are embedded in a complex interplay between excess body fat, insulin resistance and serum lipid anomalies. Endothelial homeostasis is strongly affected by this pathogenic network. Even though metabolic changes and weight loss improve vascular endothelial function, the effect of different dietary approaches is still uncertain for type 2 diabetes patients. Objective: We aimed to compare the acute effects of a hypocaloric very low carbohydrate (VLC) diet versus a hypocaloric low fat (LF) diet on flow mediated dilation (FMD), intrahepatic lipid (IHL) accumulation and visceral adipose tissue as independent risk factors of CVD in T2DM patients. Design: 36 T2DM patients (age 63 ± 8 years, 60% females) were randomly assigned to the VLC diet (4–10% of total energy intake (E)) or to the LF diet (<30% E) for 3 weeks. Endothelial function was assessed by the flow mediated dilation (FMD) method. Adipose tissue depots and IHL were determined by magnetic resonance. Results: Both dietary strategies reduced body weight, body fat content and IHL. Unexpectedly, the LF group experienced significantly greater enhancement of FMD, compared to the VLC group. The FMD showed a positive correlation with protein intake and fat intake in the LF group, while it revealed a negative correlation with protein intake in the VLC diet group. Conclusions: Reduction of total and hepatic adiposity was shown to be successful using either the VLC or LF hypocaloric diets, however, improvements in FMD may be related to the interplay of fat and protein intake.

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Hormone Therapy Impairs Endothelial Function in Postmenopausal Women with Type 2 Diabetes Mellitus Treated with Rosiglitazone

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2003-031414 ◽

2004 ◽

Vol 89 (9) ◽

pp. 4615-4619 ◽

Cited By ~ 5

Author(s):

Suzy Y. Honisett ◽

Lily Stojanovska ◽

Krishnankutty Sudhir ◽

Bronwyn A. Kingwell ◽

Tye Dawood ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Endothelial Function ◽

Hormone Therapy ◽

Postmenopausal Women ◽

Vascular Function ◽

Combined Treatment ◽

Flow Mediated Dilation ◽

Double Blind

Diabetes and ovarian senescence are associated with impaired endothelial function and altered arterial mechanical properties. Alterations in normal vascular structure and functioning are the primary cause of mortality and morbidity with type 2 diabetes. Similarly, after menopause, women experience an increase in the rate of cardiovascular disease. Thiazolidinediones have exhibited a number of antiatherogenic actions in populations with type 2 diabetes. The effect of thiazolidinediones in combination with hormone therapy (HT) in postmenopausal women is, however, unknown. To assess whether HT (transdermal estradiol 50 μg and micronized progesterone (100 mg/d) affects vascular function, 21 women receiving rosiglitazone were randomly assigned to receive HT or placebo for 12 wk in a double-blind crossover design. Measures of glycemic control, lipids, blood pressure, flow-mediated dilation, and distensibility index were undertaken at baseline and after each treatment. As a result, flow-mediated dilation was significantly reduced (15.3 ± 3.8 to 6.6 ± 1.6%, P = 0.02) with HT, whereas lipids, blood pressure, and distensibility index were unchanged. Placebo had no significant affect on any variables. Thus, the addition of HT to rosiglitazone treatment attenuates endothelial function without altering other cardiovascular risk factors. Caution should, therefore, be exercised when considering combined treatment with thiazolidinedione and HT.

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[PP.18.11] INFLUENCE OF CPAP THERAPY ON ENDOTHELIAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES ACCORDING TO FLOW-MEDIATED VASODILATION

Journal of Hypertension ◽

10.1097/01.hjh.0000523676.56451.0a ◽

2017 ◽

Vol 35 ◽

pp. e234-e235

Author(s):

V. Oleynikov ◽

N. Burko ◽

L. Salyamova ◽

Y. Tomashevskaya

Keyword(s):

Type 2 Diabetes ◽

Endothelial Function ◽

Cpap Therapy ◽

Flow Mediated Vasodilation

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Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

10.21203/rs.2.14604/v4 ◽

2020 ◽

Author(s):

Haruka Tamura ◽

Yoshinobu Kondo ◽

Kohei Ito ◽

Masanori Hasebe ◽

Shinobu Satoh ◽

...

Keyword(s):

Type 2 Diabetes ◽

Body Composition ◽

Endothelial Function ◽

Body Fluid ◽

Additional Treatment ◽

Fluid Volume ◽

Controlled Study ◽

Flow Mediated Dilation ◽

Body Fluid Volume

Abstract Abstract Background : Among patients with type 2 diabetes and established cardiovascular disease, those receiving empagliflozin have a lower rate of primary composite cardiovascular outcome and death from any cause. While treatment with sulfonylurea reduces microvascular complications in diabetes, it increases cardiovascular hospitalization or mortality in combination with metformin. In the present study, we assessed the effects of empagliflozin and glimepiride, a commonly prescribed sulfonylurea, on endothelial function using flow–mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes. Methods : In this prospective, open-label, randomized, parallel-group study, 58 patients with type 2 diabetes received metformin and glargine before bedtime for 12 weeks. This was followed by additional treatment with either 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (DFMDs), measured prior to and after 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition. Results : Analysis of the empagliflozin group ( n = 30) and glimepiride group ( n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P = 0.79). Similarly, changes in glycated hemoglobin (HbA1c) were similar between the two groups. However, significant difference in body weight changes were observed between the two groups (empagliflozin, –0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). In addition, an analysis of the body composition revealed that body fluid volume significantly decreased after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, –0.33 ± 0.72 L; P = 0.03). Conclusions : Empagliflozin did not improve endothelial function when compared to glimepiride in patients with type 2 diabetes but decreased their body fluid volume. This suggested that the coronary protective effect of empagliflozin is not derived by protection of the endothelial function but rather from reduction in the risk of heart failure. Trial Registration : This trial was registered on September 13, 2016; UMIN000024001 . Keywords: Empagliflozin, Endothelial function, Glimepiride, Diabetes, Flow–mediated dilation

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Effect of empagliflozin on brachial artery shear stress and endothelial function in subjects with type 2 diabetes: Results from an exploratory study

Diabetes and Vascular Disease Research ◽

10.1177/1479164119883540 ◽

2019 ◽

Vol 17 (1) ◽

pp. 147916411988354 ◽

Cited By ~ 2

Author(s):

Concetta Irace ◽

Antonio Cutruzzolà ◽

Martina Parise ◽

Raffaella Fiorentino ◽

Marco Frazzetto ◽

...

Keyword(s):

Type 2 Diabetes ◽

Shear Stress ◽

Endothelial Function ◽

Brachial Artery ◽

Therapy Group ◽

Glycated Haemoglobin ◽

Flow Mediated Dilation ◽

Endothelial Surface ◽

Significant Difference

Empagliflozin reduces the risk of cardiovascular mortality in subjects with type 2 diabetes. We demonstrated that empagliflozin increases blood viscosity and carotid shear stress and decreases carotid wall thickness. Shear stress is the force acting on the endothelial surface and modulates arterial function. The current study evaluates the influence of empagliflozin on brachial artery shear stress and endothelial function compared to incretin-based therapy. The study is a nonrandomized, open, prospective cohort study including 35 subjects with type 2 diabetes administered empagliflozin or incretin-based therapy. Shear stress was calculated with a validated formula, and endothelial function was evaluated using the flow-mediated dilation technique. Both treatments resulted in comparable reductions in blood glucose and glycated haemoglobin. Brachial artery shear stress significantly increased exclusively in the empagliflozin group (61 ± 20 vs 68 ± 25 dynes/cm2, p = 0.04), whereas no significant difference was detected in the incretin-based therapy group (60 ± 20 vs 55 ± 12 dynes/cm2, p = not significant). Flow-mediated dilation significantly increased in the empagliflozin group (4.8 ± 4.5% vs 8.5 ± 5.6%, p = 0.03). Again, no change was detected in the incretin-based therapy group (5.1 ± 4.5% vs 4.7 ± 4.7%, p = not significant). The present findings demonstrate the beneficial effect of empagliflozin on shear stress and endothelial function in subjects with type 2 diabetes independent of the hypoglycaemic effect.

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