Endothelial dysfunction and microangiopathic changes in first degree relatives of patients with type 2 diabetes assessed by iontophorisis

الملخص EN

ormalities in vascular reactivity in type 2 diabetes is well established.

Little is known about vascular changes in these subjects who are at risk of developing type 2 diabetes.

To address this situation endothelial function was studied in two groups with age and sex matched subjects: 14 normoglycemic normotensive first degree relative of patients with type 2 diabetes and ten subjects taken as controls.

Laser Doppler perfusion imaging was used to measure vasodilatation in the foot skin in response to iontophoresis of 1% acetylcholine (endothelium -dependent).

In the same time, maximal skin microvascular vasodilatation in response to heat was performed.

The study reveals basal skin erythrocyte reflux (SkEF) of no significant difference between both studied groups.

Peak response of skin blood flow due to dilatation effect induced by iontophoretically acetylcholine in 20sec, 40sec and 80sec was found to be significantly reduced in relatives of type 2 diabetes compared to controls.

Baseline to peak flow readings (% change) for microcirculation of the foot are still significantly reduced in first degree relatives of type 2 diabetes in response to iontophoresis by acetylcholine.

The difference in flow associated endothelium dependent vasodilatation could not be attributed to other confounding variables, because we could not show any difference as in the classic cardiovascular risk factors (age ,sex, smoking, BMIs, fasting blood glucose and blood pressure).The maximum blood flow as measured by Laser Doppler fluximetry (LDF) in response to heat was found to be some what lower in the first degree relatives of patients with type 2 diabetes but results was not of statistical significance and the difference between patients and controls was not marked.

These results suggest that abnormalities in endothelial function are present early in individuals at risk of developing type 2 diabetes, w'ell before any clinical symptoms are present , even at euglycemic stage.