Original article / research
Is Long Term Duration of Diabetes a Factor to Cause Endothelial Dysfunction in Patients with Type 2 Diabetes Mellitus?
Dr. Philips Abraham,
Professor, Department of Biochemistry, Al-Azhar Medical College
and Super Specialty Hospital, Thodupuzha,
Idukki-685608, Kerala, India.
Introduction: Endothelial Dysfunction (ED) is an earliest pathological process of atherosclerosis. Endothelium regulates vascular tone, platelet activity, leukocyte adhesion and thrombosis. Impaired function of endothelium initiates the development of atherosclerosis. Nitric oxide is one of the most effective endogenous vasodilator and also a marker for ED.
Aim: To assess whether long term duration of diabetes is a factor to cause ED and its complications in patients with Type 2 diabetes mellitus. Hence, the study has been designed to assess the ED in patients with long term duration of Type 2 diabetes for early prediction of vascular complications.
Materials and Methods: The study was conducted on 47 Type 2 diabetic subjects. Among these 27 subjects with <5 years duration of diabetes (Group-I) and remaining 20 subjects with >5 years duration of diabetes (Group-II). Glucose, HbA1c, BMI and lipid profile were estimated by well established methods in auto-analyzer, MDA by Thiobarbituric Acid Reactive Substances (TBARS), total antioxidant capacity as Ferric Reducing Ability of Plasma (FRAP) and NO was estimated by kinetic cadmium reduction method using spectrophotometer. Statistical analysis was performed by “Kruskal-Wallis” test.
Result: Significantly low level of NO was identified in Type 2 diabetic patients with >5 years duration of disease compared to <5 years duration. MDA shows significantly high value in >5 years duration of diabetes and no significant difference in the level of FRAP among the study groups was observed. It has also shown significantly high level of age in >5 years duration of Type 2 diabetes than <5 years. But, no significant differences in the levels of HbA1c, lipid profile were identified between two study groups.
Conclusion: Age and oxidative stress (lipid peroxidation) has been recognized as risk factors for ED and future complications in patients with more than 5 years duration of Type 2 diabetes.
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