Objective: To determine early stage CVD risk in type 2 DM patients using Flow Mediated Dilatation score -correlating it with acceleration of inflammatory process of vascular injury.

Methodology: Total 97(70 F 27 M) patients with T2DM of more than 10 years with age> 50years were screened for FMD score along with 60 (34 F, 26 M) healthy controls (without DM same age group), using Angiodefender (Everist Genomics Ann Arbor, MI, USA). Pro inflammatory cytokines- TNF alpha, IL-6, IL-1 were measured using standard ELISA kits. As surrogates for disease activity C-reactive protein and ESR levels were determined. A Framingham risk score was assessed in order to evaluate coronary heart disease risk at 10years in per cent. A Treadmill Stress Test (TMT) was done in patients showing endothelial dysfunction to correlate the results.

Result: The FMD score in 97 T2DM patients showed that 70.1% (n=68, 59F 9M) patients suffered from impaired endothelial function and increased arterial thickness; 16.5% (n=16, 9F 7M) patients suffered from endothelial dysfunction, arterial stiffness and atherosclerosis whereas the remaining 13.4% had normal endothelial function. In the healthy counterparts, the FMD score was normal in 80% (n= 48, 26F 22M) patients. The pro inflammatory cytokines were either normal or high in the patients with impaired endothelial function. C-reactive proteins and ESR levels varied from high to normal in patients with endothelial dysfunction. The TMT test done for the patients with impaired endothelial dysfunction and arterial stiffness showed positive results.

Conclusion: The flow mediated dilatation score can be effectively used as a marker to determine the vascular injury and endothelial dysfunction in patients with type 2 DM. 70 % of patients showed impaired endothelial function and increased arterial thickness which can be considered for counseling of patients for prevention of CVD, using the FMD tool. Acceleration of Inflammatory process could also be effectively correlated with the FMD score.

Disclosure

V. Chavda: None. D. Hasnani: None. B.D. Saboo: None. S. Shah: None. M. Saiyed: None. S. Hasnani: None.

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