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ABSTRACT
Background
Endothelial dysfunction (ED) is defined as a transformation towards injurious processes which contributes to vasoconstriction, excessive thrombosis, and irregular vascular proliferation. Endothelin-1 (ET-1) has been shown to be responsible for maintaining arterial stiffness. In ED, where nitric oxide (NO) production is low and that of ET-1 is high, the balance is changed to elevate arterial stiffness. ED depreciates more rapidly in patients with type 2 diabetes mellitus, possibly due to the toxic consequences of hyperinsulinemia in the vascular wall.
Aim: To Investigate the effects of an eight-month treatment with metformin alone and in combination with glimepiride on arterial elasticity, endothelial dysfunction (ET-1) in black type 2 diabetes mellitus patients.
Aim: To Investigate the effects of an eight-month treatment with metformin alone and in combination with glimepiride on arterial elasticity, endothelial dysfunction (ET-1) in black type 2 diabetes mellitus patients.
Method
The AtCor SphygmoCor® system (AtCor Medical, Inc., Sydney, Australia) was used to measure PWV and Aix. Endothelin-1 levels were measured using Multiplexing with Bio-Plex Pro™ human inflammation panel I assay. Type 2 diabetic treatment naïve participants were divided into two groups: metformin (M) (n = 10) and metformin glimepiride (MS) (n = 14). After treatment initiation study participants were followed up at 4 and 8 months.
Result
In the M and MS group, ET-1 levels significantly decreased at four months (7.54±4.51 pg/ml, 5.04±3.31 pg/ml) and at eight months (3.25±3.38 pg/ml, 5.09±3.01 pg/ml) when compared to baseline (24.10±11.31pg/ml) (P<0.05). In the M group, there was also a statistically significant decrease in ET-1 levels at eight months (3.25±3.4 pg/ml) when compared to four months (7.54±4.5 pg/ml) (P<0.05). PWV was directly correlated to ET-1 (r2=0.16073; P=0.0450). There was no correlation between Aix and ET-1 (r2=0.09838; P=0.2218).
Conclusion
Metformin alone and in combination with glimepiride significantly decreased ET-1 levels over the period of eight months treatment. There was positive correlation between PWV and ET-1 levels indicating possible improvement of arterial elasticity with longer-term T2DM treatment in black participants.