2. Study Of Vascular Endothelial Dysfunction In Patients with Diabetes Mellitus By Flow Mediated Dilation Of Brachial Artery,

Dinesh Choudhary, Jitendra Acharya, Rakesh Garg,

Int Res Pub Med Sci, 2015;1(3):7-16.

ABSTRACT

Background: Endothelial dysfunction (ED) has a pivotal role in the atherosclerosis and in atherosclerosis related diseases such as coronary artery disease. We aimed to diagnose ED in diabetes mellitus (DM) patients by Colour Doppler, B-mode ultrasound using ?ow mediated vascular responses [reactive hyperemia]. Methods & Results: We measured end-diastolic diameter of the brachial artery in longitudinal section at rest, after stress [Flow Mediated Dilation: FMD] and after 400 microgram nitroglycerin puff sublingually [Nitrate Mediated Dilation: NMD]. FMD & NMD in 20 control subjects & 40 DM patients were compared. There was no signi?cant difference [p > 0.05] in brachial artery diameter at rest [4.12+/-0.56 Vs 4.09+/- 0.50 mm in controls & cases respectively]. Non-DM group showed signi?cantly higher [p<0.05] FMD [9.48+/-5.63%] than DM group [6.00+/-2.92%]. NMD was marginally reduced in the DM group than Non-DM group [13.63+/-5.50 Vs 15.54+/-7.50%] but no signi?cant difference could be deduced [p>0.05]. Patients of DM with ?5 yrs duration had decreased FMD than those with DM of 0.05]. Conclusion: Signi?cant reduction in FMD was recorded in DM patients, signifying endothelial dysfunction. This non invasive method of FMD of brachial artery may diagnose the atherosclerotic stage in diabetic patients at a very early stage and should be used in all diabetic patients, especially in poorly controlled and long duration of DM but larger studies in this regard are needed to con?rm our ?ndings.

Key-words: Diabetes Mellitus, Endothelial dysfunction, Flow Mediated Dilation, Nitrate Mediated Dilation.

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