Doenças Cardiovasculares e Diagnóstico

Endothelial Dysfunction Evaluated using Photoplethysmography in Patients with Type 2 Diabetes

Abstract

Castillo-Martinez Lilia, Ortiz-Suarez Gerson, Montanez-Orozco Alvaro, Orea-Tejeda Arturo, Keirns-Davis Candace, Davila-Radilla Fernando, Alcala- Davila Efraín, Kauffman-Ortega Eric, Infante-Vazquez Oscar and Martinez Memije Raul

Background: Diabetes mellitus (DM) reduces life expectancy by a third, principally because of cardiovascular disease and endothelial dysfunction is considered to be one of the first manifestations of vascular disease. Photoplethysmography is a non-invasive technique to evaluate endothelial dysfunction based on the emission of infra-red light on the skin.

Objective: To evaluate endothelial function by photoplethysmography in patients with type 2 DM without evidence of vascular disease.

Methods: A cross-sectional study of patients with and without DM was undertaken. Endothelial function was evaluated using photoplethysmographic waves taking into consideration the shape of the curve and time of maximum amplitude/total time of the curve (TMA/TT) before and after ischemia induced by arterial obstruction.

Results: In 174 subjects included, a greater basal TMA/TT index was found in diabetics, even after adjusting for age, hypertension, dyslipidemia and hypothyroidism. The percent change in amplitude post-ischemia compared to basal value was diminished in diabetics (p=0.030). Persons with diabetes, with and with not endothelial dysfunction, had comparable HbA1c concentrations; but diabetics with endothelial dysfunction, had lower serum concentration of HDL-C. (p=0.05) Conclusions: More endothelial dysfunction was found in patients with diabetes. While the control of diabetes did not influence endothelial dysfunction, it was associated with HDL cholesterol.