2216-PUB: More Precise Assessment of Flow-Mediated Dilation (FMD) by Measuring at Maximum Dilatory Peak Time (MDP) in Subjects With and Without Type 2 Diabetes (T2D)

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2216-PUB
Author(s):  
THERESA HERBRAND ◽  
HANS VEIT COESTER ◽  
J. HANS DEVRIES ◽  
CHRISTIAN HEISS ◽  
TIM HEISE ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peak Time ◽  
Flow Mediated Dilation ◽  
Precise Assessment

Improving the Assessment of Flow-Mediated Dilation Through Detection of Peak Time in Healthy Subjects and Subjects With Type 2 Diabetes

Angiology ◽  
2020 ◽  
pp. 000331972098488
Author(s):  
Theresa Herbrand ◽  
Hans-Veit Coester ◽  
Roberto Sansone ◽  
Annelie Fischer ◽  
Christian Heiss ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sample Size ◽  
Healthy Subjects ◽  
Substantial Reduction ◽  
Intraindividual Variability ◽  
Peak Time ◽  
Flow Mediated Dilation ◽  
Fold Reduction ◽  
Precise Assessment

The assessment of flow-mediated dilation (FMD) is widely used to quantify endothelial function. Historically, FMD was determined at 60 seconds post-cuff deflation. We investigated whether FMD would be more accurate if determined at maximum dilatory peak (MDP) than at 60 seconds in healthy subjects and subjects with type 2 diabetes mellitus (T2DM). We studied 95 healthy and 72 subjects with T2DM and assessed FMD at MDP, 60 and 90 seconds. Twenty-four healthy and 12 subjects with T2DM underwent a repeat FMD after 28 days. In healthy subjects, FMD at MDP was higher than at 60 and 90 seconds, with mean difference MDP versus 60 seconds 1.14% (95% CI: 0.6-1.7); P < .0001 and MDP versus 90 seconds 1.9% (95% CI: 1.3-2.5) with similar results in T2DM, that is, 1.0% (95% CI: 0.1-1.9) and 2.3% (95% CI: 1.3-3.2), respectively. Intraindividual variability was lowest with MDP compared with 60 and 90 seconds, that is, 15.0 versus 23.2% and 40.0%, respectively, resulting in a more than 2-fold reduction in necessary sample size. In healthy subjects and subjects with T2DM, assessment of FMD using MDP results in a more accurate and precise assessment leading to a substantial reduction in sample size.

scholarly journals Acute Endothelial Benefits of Fat Restriction over Carbohydrate Restriction in Type 2 Diabetes Mellitus: Beyond Carbs and Fats

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1859 ◽  
Author(s):  
Renate Barbosa-Yañez ◽  
Ulrike Dambeck ◽  
Linna Li ◽  
Jürgen Machann ◽  
Stefan Kabisch ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adipose Tissue ◽  
Endothelial Function ◽  
Body Fat ◽  
Protein Intake ◽  
Diet Group ◽  
Flow Mediated Dilation ◽  
Reduced Body ◽  
Diabetes Patients

Background: Cardiovascular diseases (CVD) are the major cause of mortality in type 2 diabetes patients (T2DM). The causes are embedded in a complex interplay between excess body fat, insulin resistance and serum lipid anomalies. Endothelial homeostasis is strongly affected by this pathogenic network. Even though metabolic changes and weight loss improve vascular endothelial function, the effect of different dietary approaches is still uncertain for type 2 diabetes patients. Objective: We aimed to compare the acute effects of a hypocaloric very low carbohydrate (VLC) diet versus a hypocaloric low fat (LF) diet on flow mediated dilation (FMD), intrahepatic lipid (IHL) accumulation and visceral adipose tissue as independent risk factors of CVD in T2DM patients. Design: 36 T2DM patients (age 63 ± 8 years, 60% females) were randomly assigned to the VLC diet (4–10% of total energy intake (E)) or to the LF diet (<30% E) for 3 weeks. Endothelial function was assessed by the flow mediated dilation (FMD) method. Adipose tissue depots and IHL were determined by magnetic resonance. Results: Both dietary strategies reduced body weight, body fat content and IHL. Unexpectedly, the LF group experienced significantly greater enhancement of FMD, compared to the VLC group. The FMD showed a positive correlation with protein intake and fat intake in the LF group, while it revealed a negative correlation with protein intake in the VLC diet group. Conclusions: Reduction of total and hepatic adiposity was shown to be successful using either the VLC or LF hypocaloric diets, however, improvements in FMD may be related to the interplay of fat and protein intake.

scholarly journals Comparison of brachial artery flow-mediated dilation in youth with type 1 and type 2 diabetes mellitus

2014 ◽  
Vol 5 (5) ◽  
pp. 615-620 ◽  
Author(s):  
Koji Ohsugi ◽  
Hidenori Sugawara ◽  
Kanako Ebina ◽  
Kentaro Shiga ◽  
Nobuyuki Kikuchi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Brachial Artery ◽  
Flow Mediated Dilation ◽  
Artery Flow

PS 17-18 DYNAMICS OF PARAMETERS OF ENDOTHELIAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES ACCORDING TO FLOW-MEDIATED DILATION DURING THE CPAP-THERAPY

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e478-e479
Author(s):  
Valentin Oleynikov ◽  
Nadezhda Burko ◽  
Lyudmila Salyamova ◽  
Natalia Borisova
Keyword(s):  
Type 2 Diabetes ◽  
Endothelial Function ◽  
Flow Mediated Dilation ◽  
Cpap Therapy

scholarly journals Targeting Inflammation Using Salsalate in Patients With Type 2 Diabetes: Effects on Flow-Mediated Dilation (TINSAL-FMD)

Diabetes Care ◽  
2013 ◽  
Vol 36 (12) ◽  
pp. 4132-4139 ◽  
Author(s):  
A. B. Goldfine ◽  
J. S. Buck ◽  
C. Desouza ◽  
V. Fonseca ◽  
Y.-D. I. Chen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Flow Mediated Dilation

P2429More precise assessment of flow-mediated dilation by measuring individually determined maximum dilatory peak time in healthy middle-aged subjects and patients with diabetes mellitus type 2

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Herbrand ◽  
H V Coester ◽  
H De Vries ◽  
C Heiss ◽  
T Heise ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Healthy Subjects ◽  
Diabetes Mellitus Type 2 ◽  
Least Square ◽  
Peak Time ◽  
Flow Mediated Dilation ◽  
Middle Aged ◽  
Time Points ◽  
Aged Subjects

Abstract The assessment of flow-mediated dilation (FMD) is widely used in clinical research to quantify endothelial function. FMD is calculated by subtracting the artery's baseline diameter from the peak diameter during hyperemia. However, there is no consensus on how to determine peak diameter. Many authors report FMD results based on values assessed at predefined time points. This may limit the accuracy and reproducibility of FMD. We hypothesised that FMD values using maximum dilatory peak time (MDP) would differ from those using predefined time points. Using individually determined MDP may lead to a lower number of subjects needed to show significance for a given difference in FMD. FMD was measured in middle-aged subjects with and without diabetes mellitus type 2 (T2DM) by ultrasound (12-MHz transducer). In a subset of subjects, FMD was measured again 30 days later. All measurements were performed by certified research physicians and evaluated using appropriate software. FMD values were compared at 60 s and 90 s after start of hyperaemia and at MDP during hyperaemia. FMD was measured in 100 healthy subjects and 72 subjects with T2DM (mean ± SD age 57±6 years, healthy: body mass index 26.2±3 kg/m2, blood pressure 127±10 /80±7 mmHg, DMT2: body mass index 29±3 kg/m2, blood pressure 135±11 / 86±5 mmHg, HbA1c 7.1±0.7%). FMD in healthy subjects was lower at predefined time points compared to MDP (least square mean difference (95% CI)) 60 s vs. MDP −1.14% (−1.72 to −0.56; p<0.0001) and 90 s vs. MDP −1.87% (−2.48 to −1.26; p<0.0001). Also in subjects with DMT2, FMD at predefined time points was lower compared to MDP (least square mean difference (95% CI)) 60 s vs. MDP −1.08% (−1.71 to −0.44; p<0.001) and 90 s vs. MDP −1.73% (−2.38 to −1.06; p<0.001). The intra-subject variability was lowest for MDP compared to 60 s and 90 s (15% vs. 36% and 51%, respectively). Assuming 80% power and alpha at 0.05, the individually determined peak requires 15 people to detect a 1% difference in FMD versus 26 subjects if determined at 60 s and 31 subjects if determined at 90 s. This study demonstrated significantly higher FMD values and superior reproducibility of the individually determined maximum dilatory peak compared to peaks at predefined time points in healthy middle-aged people and patients with type 2 diabetes. This roughly halves the number of study participants needed to detect a 1% difference in FMD.

The Relative Efficacy of Land-Based and Water-Based Exercise Training on Macro- and Microvascular Functions in Older Patients With Type 2 Diabetes

2017 ◽  
Vol 25 (3) ◽  
pp. 446-452 ◽  
Author(s):  
Saowaluck Suntraluck ◽  
Hirofumi Tanaka ◽  
Daroonwan Suksom
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Older Patients ◽  
Hemoglobin A1c ◽  
Blood Glucose Concentration ◽  
Warm Water ◽  
Flow Mediated Dilation ◽  
Cycling Exercise ◽  
Water Based

Microvascular and macrovascular dysfunction plays an important role in the pathogenesis of diabetic vascular disease. Twenty-nine older patients with type 2 diabetes were randomly assigned into the land-based (LB; n = 14) or water-based (WB; n = 15) groups. Both groups completed supervised aerobic cycling exercises three times per week for 12 weeks. The WB group performed cycling exercise training in warm water (36 °C) immersed to the hip level. After 12 weeks, blood glucose concentration and insulin resistance did not change but hemoglobin A1c levels decreased (P < .05) in both groups. Plasma nitric oxide concentrations increased (P < .05) in both groups. Flow-mediated dilation in the popliteal artery increased and arterial stiffness decreased (P < .05) in both exercise groups. Indices of microvascular reactivity improved (P < .05) only in the WB group. The benefits of warm water-based training were similar in general, and superior in some measures, to the more established land-based cycling exercise.

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