Vascular phenotype and subclinical inflammation in diabetic Asian Indians without overt cardiovascular disease

Ray, A.; Beishuizen, E.D.; Misra, A.; Huisman, M.V.; Tamsma, J.T.

doi:10.1016/j.diabres.2006.09.021

« Previous Next »Diabetes Research and Clinical Practice
Volume 76, Issue 3 , Pages 390-396, June 2007

Vascular phenotype and subclinical inflammation in diabetic Asian Indians without overt cardiovascular disease

A. Ray
- Vascular Medicine Unit, Department of Endocrinology and General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Corresponding author at: Vascular Medicine Unit, Department of Endocrinology and General Internal Medicine, Leiden University Medical Center, P.O. Box 9600, C4, 2300 RC Leiden, The Netherlands. Tel.: +31 71 526 4680; fax: +31 71 524 8140.
E.D. Beishuizen
- Vascular Medicine Unit, Department of Endocrinology and General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
A. Misra
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
M.V. Huisman
- Vascular Medicine Unit, Department of Endocrinology and General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
J.T. Tamsma
- Vascular Medicine Unit, Department of Endocrinology and General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands

Received 18 May 2006; accepted 19 September 2006. published online 25 October 2006.

Abstract

Although Asian Indian (AI) patients with diabetes mellitus type 2 (DM2) are at high risk for cardiovascular disease (CVD), not all patients develop CVD. The vascular phenotype of AI-DM2 without CVD has not been elucidated and may point to protective features. Using baseline data from a clinical trial we provide an initial description of vascular parameters in AI-DM2 compared to Europid Caucasian controls (ECs) matched for age and gender. Endpoints of the study were endothelial function, low-grade systemic inflammation (CRP) and carotid intima-media thickness (cIMT).

AIs had longer duration of diabetes, worse glycemic control and more microangiopathy. Both groups demonstrated marked endothelial dysfunction. CRP levels were similar: 1.7 (4.9) mg/L in AIs and 2.8 (3.6) mg/L in ECs. cIMT values were significantly lower in AI-DM2 than EC-DM2 (0.655mm (0.12) versus 0.711mm (0.15), p=0.03). Multiple regression analysis showed that variability in CRP was mainly determined by waist circumference, not by ethnicity. In contrast, ethnicity was a significantly explanatory variable for cIMT.

Vascular phenotype of AI-DM2 without CVD was characterized by endothelial dysfunction and relatively low levels of CRP, comparable to EC-DM2 controls. In contrast, lower cIMT values were observed in AI-DM2 despite longer duration of diabetes and worse metabolic control. We propose that mechanisms slowing its progression may have atheroprotective potential in AI-DM2.

Keywords: Cardiovascular disease, Ethnicity, Intima-media thickness, Asian Indians, Inflammation