Brachial artery reactivity in asymptomatic patients with type 2 diabetes mellitus and microalbuminuria (from the Detection of Ischemia in Asymptomatic Diabetics–Brachial Artery Reactivity study)☆
Section snippets
Patient population
The patient cohort consisted of subjects enrolled in the DIAD study who underwent assessment of BAR (DIAD-BAR substudy). The DIAD study is a prospective, multicenter, randomized trial that evaluates the prevalence of adenosine technetium-99m sestamibi myocardial perfusion imaging abnormalities in asymptomatic patients with type 2 DM and its association with adverse clinical outcomes. Eligible patients had asymptomatic type 2 DM, were 50 to 75 years old, and had no known coronary artery disease.
Baseline characteristics
The baseline clinical and biochemical characteristics of the entire study population are listed in Table 1. There were no significant differences between groups regarding use of medications (Table 2) with the exceptions of thiazolidinediones being used more frequently in patients with microalbuminuria (p = 0.05), and hormone replacement therapy was less prevalent in patients with microalbuminuria than in those with normoalbuminuria (p = 0.04).
Relation between microalbuminuria and brachial artery reactivity
There was a trend for larger baseline brachial
Discussion
The aim of this study was to investigate the relation between microalbuminuria and BAR in asymptomatic patients with DM. Our results demonstrated that patients with microalbuminuria have significant impairment of EDV and EIV compared with those with normoalbuminuria and a higher degree of systemic inflammation. These data associated the presence of microalbuminuria in patients with DM with impaired vascular reactivity secondary to smooth muscle dysfunction rather than to endothelial dysfunction
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This study was supported by grants from the Hartford Hospital Research Administration, Hartford, Connecticut, and Bristol-Myers Squibb Medical Imaging, North Billerica, Massachusetts.