Endothelial dysfunction in Type 1 diabetic subjects with and without microalbuminuria

SummaryAims The primary aim of this study was to determine whether micro‐ albuminuria is associated with endothelial dysfunction in Type 1 diabetes mellitus. The secondary aim was to determine whether any reported bio‐ chemical markers of cardiovascular risk are associated with endothelial dysfunction in this group. Methods Measurements were made of the vasodilatory responses of the brachial artery to post‐ischaemic hyperaemia and to sublingual glyceryl trinitrate (GTN) (causing endothelium‐dependent and endothelium‐independent dilation, respectively) using a high‐resolution ultrasound technique in 18 Type 1 diabetic patients with microalbuminuria, 18 age and sex‐matched normoalbuminuric Type 1 diabetic patients and 18 non‐diabetic control subjects. Results There was a significant reduction in flow‐mediated dilation (FMD) in microalbuminuric and normoalbuminuric diabetic patients compared with control subjects (2.4% (95% confidence interval (CI) 1.0–3.8%) and 2.3% (95% CI 0.7–3.9%) respectively vs. 6.3% (95% CI 5.1–7.5%), P < 0.0001) but no difference in GTN‐mediated dilation (14.7% (95% CI 10.7–18.7%) and 15.2% (95% CI 11.2–19.2%) vs. 18.7% (95% CI 16.1–21.3%), P = 0.09). There