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International Angiology 1998 June;17(2):97-102


language: English

Plasma endothelin-1 concentrations in non-insulin-dependent diabetes mellitus and nondiabetic patients with chronic arterial obstructive disease of the lower limbs

Mangiafico R. A., Malatino L. S., Santonocito M., Spada R. S.

From the Institute of Internal Medicine “L. Condorelli”, University of Catania, Catania, Italy


Background. Endothelin-1 (ET-1), a vas­o­con­stric­tor and mit­o­gen­ic endo­the­li­um-­derived pep­tide, has been con­sid­ered as a mark­er for endo­the­lial dam­age and poten­tial con­trib­u­tor to the devel­op­ment of the ather­o­gen­ic pro­cess.
Methods. To eval­u­ate the pat­tern of plas­ma ET-1 secre­tion in non-insu­lin-depen­dent dia­betes mel­lit­us (NIDDM) and non­di­a­bet­ic ­patients with chron­ic arte­ri­al obstruc­tive dis­ease (CAOD) of the lower limbs, plas­ma lev­els of ET-1 were deter­mined in 12 NIDDM ­patients (10 men and 2 women; mean age 63±8 years) with CAOD of the lower limbs at Fontaine stage II and in 12 non­di­a­bet­ic ­patients (11 men and 1 woman; mean age 62±4 years) with com­par­able arter­i­op­a­thy. Ten nor­mal sub­jects com­prised the con­trol pop­u­la­tion.
Results. The plas­ma lev­els of ET-1 in NIDDM ­patients with CAOD of the lower limbs were 5.7±0.3 pmol/L, which rep­re­sent­ed a sig­nif­i­cant (p<0.001) dif­fer­ence from the val­ues in non­di­a­bet­ic ­patients with com­par­able arter­i­op­a­thy (4.1±0.6 pmol/L) and those in the con­trol group (2.7±0.7 pmol/L). Plasma lev­els of ET-1 ­showed a sig­nif­i­cant (p<0.0001) pos­i­tive cor­re­la­tion with the lev­els of fast­ing insu­lin in NIDDM ­patients with CAOD of the lower limbs. Increased plas­ma ET-1 could ­reflect a major and/or more dif­fuse endo­the­lial cell dam­age or dys­func­tion in NIDDM than in non­di­a­bet­ic ­patients with com­par­able CAOD of the lower limbs. Augmented mit­o­gen­ic ET-1 lev­els could also have a role both in dia­bet­ic and non­di­a­bet­ic angio­pa­thy.
Conclusions. The pos­i­tive cor­re­la­tion ­between ET-1 plas­ma lev­els and fast­ing insu­lin lev­els in NIDDM ­patients with CAOD of the lower limbs sug­gests that the ­increased ET-1 ­release could be relat­ed to the aug­ment­ed insu­lin secre­tion in these ­patients. Insulin-relat­ed over­pro­duc­tion of ET-1 could pro­mote the ather­o­gen­ic pro­cess and ­enhance the vas­cu­lar tone to a great­er ­extent in NIDDM than in non­di­a­bet­ic ­patients with CAOD of the lower limbs.

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