Targeting Inflammation Using Salsalate in Patients With Type 2 Diabetes: Effects on Flow-Mediated Dilation (TINSAL-FMD)

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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Comparison of brachial artery flow-mediated dilation in youth with type 1 and type 2 diabetes mellitus

Journal of Diabetes Investigation ◽

10.1111/jdi.12191 ◽

2014 ◽

Vol 5 (5) ◽

pp. 615-620 ◽

Cited By ~ 6

Author(s):

Koji Ohsugi ◽

Hidenori Sugawara ◽

Kanako Ebina ◽

Kentaro Shiga ◽

Nobuyuki Kikuchi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Brachial Artery ◽

Flow Mediated Dilation ◽

Artery Flow

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

Journal of Hypertension ◽

10.1097/01.hjh.0000501280.33564.8b ◽

2016 ◽

Vol 34 (Supplement 1) ◽

pp. e478-e479

Author(s):

Valentin Oleynikov ◽

Nadezhda Burko ◽

Lyudmila Salyamova ◽

Natalia Borisova

Keyword(s):

Type 2 Diabetes ◽

Endothelial Function ◽

Flow Mediated Dilation ◽

Cpap Therapy

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Dapagliflozin vs Empagliflozin on Flow Mediated Dilation in Type 2 Diabetes Mellitus

Case Medical Research ◽

10.31525/ct1-nct04195243 ◽

2019 ◽

Author(s):

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Flow Mediated Dilation

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Improving the Assessment of Flow-Mediated Dilation Through Detection of Peak Time in Healthy Subjects and Subjects With Type 2 Diabetes

Angiology ◽

10.1177/0003319720984884 ◽

2020 ◽

pp. 000331972098488

Author(s):

Theresa Herbrand ◽

Hans-Veit Coester ◽

Roberto Sansone ◽

Annelie Fischer ◽

Christian Heiss ◽

...

Keyword(s):

Type 2 Diabetes ◽

Sample Size ◽

Healthy Subjects ◽

Substantial Reduction ◽

Intraindividual Variability ◽

Peak Time ◽

Flow Mediated Dilation ◽

Fold Reduction ◽

Precise Assessment

The assessment of flow-mediated dilation (FMD) is widely used to quantify endothelial function. Historically, FMD was determined at 60 seconds post-cuff deflation. We investigated whether FMD would be more accurate if determined at maximum dilatory peak (MDP) than at 60 seconds in healthy subjects and subjects with type 2 diabetes mellitus (T2DM). We studied 95 healthy and 72 subjects with T2DM and assessed FMD at MDP, 60 and 90 seconds. Twenty-four healthy and 12 subjects with T2DM underwent a repeat FMD after 28 days. In healthy subjects, FMD at MDP was higher than at 60 and 90 seconds, with mean difference MDP versus 60 seconds 1.14% (95% CI: 0.6-1.7); P < .0001 and MDP versus 90 seconds 1.9% (95% CI: 1.3-2.5) with similar results in T2DM, that is, 1.0% (95% CI: 0.1-1.9) and 2.3% (95% CI: 1.3-3.2), respectively. Intraindividual variability was lowest with MDP compared with 60 and 90 seconds, that is, 15.0 versus 23.2% and 40.0%, respectively, resulting in a more than 2-fold reduction in necessary sample size. In healthy subjects and subjects with T2DM, assessment of FMD using MDP results in a more accurate and precise assessment leading to a substantial reduction in sample size.

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The Relative Efficacy of Land-Based and Water-Based Exercise Training on Macro- and Microvascular Functions in Older Patients With Type 2 Diabetes

Journal of Aging and Physical Activity ◽

10.1123/japa.2016-0193 ◽

2017 ◽

Vol 25 (3) ◽

pp. 446-452 ◽

Cited By ~ 11

Author(s):

Saowaluck Suntraluck ◽

Hirofumi Tanaka ◽

Daroonwan Suksom

Keyword(s):

Type 2 Diabetes ◽

Exercise Training ◽

Older Patients ◽

Hemoglobin A1c ◽

Blood Glucose Concentration ◽

Warm Water ◽

Flow Mediated Dilation ◽

Cycling Exercise ◽

Water Based

Microvascular and macrovascular dysfunction plays an important role in the pathogenesis of diabetic vascular disease. Twenty-nine older patients with type 2 diabetes were randomly assigned into the land-based (LB; n = 14) or water-based (WB; n = 15) groups. Both groups completed supervised aerobic cycling exercises three times per week for 12 weeks. The WB group performed cycling exercise training in warm water (36 °C) immersed to the hip level. After 12 weeks, blood glucose concentration and insulin resistance did not change but hemoglobin A1c levels decreased (P < .05) in both groups. Plasma nitric oxide concentrations increased (P < .05) in both groups. Flow-mediated dilation in the popliteal artery increased and arterial stiffness decreased (P < .05) in both exercise groups. Indices of microvascular reactivity improved (P < .05) only in the WB group. The benefits of warm water-based training were similar in general, and superior in some measures, to the more established land-based cycling exercise.

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Relationship between changes in brachial artery flow-mediated dilation and basal release of nitric oxide in subjects with Type 2 diabetes

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01176.2005 ◽

2006 ◽

Vol 291 (3) ◽

pp. H1193-H1199 ◽

Cited By ~ 15

Author(s):

Daniel J. Green ◽

Andrew J. Maiorana ◽

Michael E. Tschakovsky ◽

Kyra E. Pyke ◽

Cara J. Weisbrod ◽

...

Keyword(s):

Nitric Oxide ◽

Type 2 Diabetes ◽

Brachial Artery ◽

Control Period ◽

Angiotensin Ii Receptor Blocker ◽

Flow Mediated Dilation ◽

Basal Resistance ◽

Resistance Vessel ◽

Conduit Artery

Assessment of flow-mediated dilation (FMD) after forearm ischemia is widely used as a noninvasive bioassay of stimulated nitric oxide (NO)-mediated conduit artery vasodilator function in vivo. Whether this stimulated endothelial NO function reflects basal endothelial NO function is unknown. To test this hypothesis, retrospective analysis of randomized crossover studies was undertaken in 17 subjects with Type 2 diabetes; 9 subjects undertook an exercise training or control period, whereas the remaining 8 subjects were administered an angiotensin II receptor blocker or placebo. FMD was assessed by using wall tracking of high-resolution brachial artery ultrasound images in response to reactive hyperemia. Resistance vessel basal endothelium-dependent NO function was assessed by using intrabrachial administration of NG-monomethyl-l-arginine (l-NMMA) and plethysmographic assessment of forearm blood flow (FBF). FMD was higher after intervention compared with control/placebo (6.15 ± 0.53 vs. 3.81 ± 0.72%, P < 0.001). There were no significant changes in the FBF responses to l-NMMA. Regression analysis between FMD and l-NMMA responses at entry to the study revealed an insignificant correlation ( r = −0.10, P = 0.7), and improvements in FMD with the interventions were not associated with changes in the l-NMMA responses ( r = −0.04, P = 0.9). We conclude that conduit artery-stimulated endothelial NO function (FMD) does not reflect basal resistance vessel endothelial NO function in subjects with Type 2 diabetes.

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PDE5 Inhibitors in Type 2 Diabetes Cardiovascular Complications

Endocrines ◽

10.3390/endocrines1020009 ◽

2020 ◽

Vol 1 (2) ◽

pp. 90-101

Author(s):

Federica Barbagallo ◽

Federica Campolo ◽

Edoardo Franceschini ◽

Elena Crecca ◽

Riccardo Pofi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Ischemia Reperfusion Injury ◽

Ischemia Reperfusion ◽

Cardiovascular Complications ◽

Flow Mediated Dilation ◽

Pde5 Inhibitors ◽

Inflammatory State ◽

Phosphodiesterase Type ◽

Dilation Rate

Pharmacological inhibition of Phosphodiesterase type 5 (PDE5) proved its efficacy treating several pathological conditions, such as erectile dysfunction and pulmonary hypertension. Nowadays, its benefits on cardiovascular diseases are well documented, particularly in the treatment of type 2 diabetes (T2DM)-related cardiovascular complications. In this context, treatment of T2DM with PDE5 inhibitors, such as sildenafil, tadalafil or vardenafil ameliorates endothelial dysfunction both in patients and animal models through an augmented flow mediated dilation rate and an up-regulation of endothelial markers; it also reduces the inflammatory state by down-regulating inflammatory cytokines expression and improves diabetic cardiomyopathy and ischemia-reperfusion injury mainly through the activation of NO-cGMP-PKG pathway. The present review summarizes the state of art on PDE5 inhibition in the treatment of cardiovascular complications in T2DM.

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