Cigarette smoking and albuminuria are associated with impaired arterial smooth
muscle function in patients with type 2 diabetes mellitus: a FIELD substudy.
Author(s): Harmer JA(1), Keech AC(2), Veillard AS(3), Skilton MR(4), Marwick TH(5), Watts
GF(6), Meredith IT(7), Celermajer DS(4); FIELD Vascular Study Investigators.
Affiliation(s): Author information:
(1)Sydney Medical School, University of Sydney, Sydney, NSW, Australia;
Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia;
NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.
Electronic address: jhar2154@uni.sydney.edu.au. (2)Sydney Medical School,
University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal
Prince Alfred Hospital, Sydney, NSW, Australia; NHMRC Clinical Trials Centre,
University of Sydney, Sydney, NSW, Australia. (3)NHMRC Clinical Trials Centre,
University of Sydney, Sydney, NSW, Australia. (4)Sydney Medical School,
University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal
Prince Alfred Hospital, Sydney, NSW, Australia. (5)Menzies Research Institute
Tasmania, Hobart, TAS, Australia. (6)Department of Medicine, University of
Western Australia, Perth, WA, Australia. (7)Department of Medicine, Monash
University, Melbourne, VIC, Australia.
Publication date & source: 2014, Diabetes Res Clin Pract. , 106(2):328-36
AIM: Impaired arterial function has been implicated in diabetes-related
atherosclerosis, but its determinants in high-risk adults have not been well
characterised. We investigated factors associated with impaired arterial function
in adults with type 2 diabetes.
METHODS: Flow-mediated dilatation (a marker of endothelial function) and dilator
response to glyceryl trinitrate (to assess smooth muscle function) of the
brachial artery were assessed at baseline in 193 patients with type 2 diabetes
from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.
Traditional risk factors were assessed and a multivariable model was constructed
to identify factors independently associated with impaired arterial function.
RESULTS: Median age was 64 years (interquartile range, 58-69; 61% male) and
duration of diabetes was 4 years (interquartile range, 2-9). Flow-mediated
dilatation (3.06 ± 0.25%, mean ± SEM) was severely impaired but not significantly
associated with other risk factors. Dilator responses to glyceryl trinitrate
(10.56 ± 0.52%) were significantly and independently impaired in past and present
cigarette smokers (P = 0.005) and in subjects with increased urinary
albumin/creatinine ratio (P = 0.01).
CONCLUSIONS: In adults with type 2 diabetes and known or suspected
atherosclerosis, arterial smooth muscle-dependent dilatation was shown to be
significantly impaired in cigarette smokers and those with elevated urinary
albumin levels.
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