PS-C17-1: PERIPHERAL MICROVASCULAR DYSFUNCTION IN SUBJECTS WITH TYPE2 DIABETES(T2DM) IN ACCORDANCE WITH ABSENCE OR PRESENCE OF CORONARY ARTERY DISEASE.

Abstract

Background: Several studies demonstrated that endothelial function is impaired in patients with T2DM, but no study evaluated vascular parameters in patients with T2DM trough a combined analysis of macro and micro-endothelial function and arterial stiffness indexes. In addition, the difference in vascular parameters between T2DM patients with CAD and without CAD remains unknown. We assessed whether coronary artery disease is associated with impairment of peripheral endothelial function and arterial stiffness indexes in patients with T2DM. Methods: We measured vascular function in 219 T2DM subjects (age 68 ± 10 years), including 147 subjects with CAD (CAD group) and 72 subjects without CAD (control group). Flow mediated vasodilatation (FMD) indicating endothelial function in a conduit artery was measured by ultrasound using a semi-automatic device: UNEXEF18G (UNEX Co. Nagoya, Japan). Reactive hyperemia index (RHI) indicating peripheral endothelial function and Augmentation index (AI) indicating arterial stiffness were measured by peripheral arterial tonometry (EndoPAT 2000). Vascular function tests were measured on the same day. Results: RHI and AI was significantly impaired in CAD group (RHI: 2.0 ± 0.7 vs.1.7 ± 0.5 P = 0.012, AI: 30.2 ± 18.1 vs.22.1 ± 19.1 P = 0.043), however FMD had no deference in the two groups. Logistic regression analysis revealed that RHI (odds ratio: 0.44, 95% confidence interval: 0.21–0.94) was an independent predictor for CAD in subjects with T2DM. Conclusions: RHI, an acknowledged marker of microcirculatory endothelial function was a more sensitive method in evaluating the risk assessment of CAD in subjects with T2DM.