Volume 26, Issue 126, August 2022

Assessment of endothelial function in prediabetes using Flow Mediated Dilatation (FMD) by applying sphygmomanometer cuff in a limited resources rural setup: A case control study

Yash Gupte^1♦, Sourya Acharya², Sunil Kumar², Samarth Shukla³, Suresh Phatak⁴, Nipun Bawiskar¹, Vidyashree Hulkoti¹, Shivam Khanna¹

¹Senior Resident, Dept. of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha-442001, Maharashtra, India
²Professor, Dept. of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha-442001, Maharashtra, India
³Professor, Dept. of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha-442001, Maharashtra, India
⁴Professor, Dept. of Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha-442001, Maharashtra, India

^♦Corresponding author
Senior Resident, Dept. of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha-442001, Maharashtra, India

ABSTRACT

Background: Diabetes mellitus is a life-threatening disease that affects both developing and industrialised countries. Prediabetes is a state where identification of the risk factors can help in preventing the complications of diabetes. Coronary artery disease and cardiovascular disease result from atherosclerosis seen in hyperglycemic states which is manifested early on as endothelial dysfunction. In this study, we used flow mediated dilatation (FMD) of brachial artery with ultrasound which gives knowledge about endothelial function in disease as well as health. Aims: To assess endothelial function in individuals diagnosed with prediabetes using FMD of brachial artery and compare it with healthy non-diabetic subjects. We also assessed if FMD was affected by anthropometric parameters or lipid profile. Methods: This case control research comprised of 50 patients who met the American Diabetes Association prediabetes criteria (ADA) and 50 controls. Clinical history was taken and data related to brachial artery diameter at baseline and post hyperemia was taken and FMD% was calculated. Results: Out of 50 patients, 4 patients had FMD (<4.5%) and were classified as having endothelial dysfunction. It was found that patients classified as Obese as per BMI (kg/m2) were significantly higher in cases that had FMD<4.5% (27.08 ± 0.97 vs. 23.51 ± 2.54, p value=0.008). Conclusion: Individuals with prediabetes did not have significantly lower brachial artery diameter at baseline, post-hyperemia brachial artery diameter and FMD. But we found that diameters of the brachial artery at rest and post stress and FMD% were significantly affected by parameters like LDL, waist circumference and BMI.

Keywords: Prediabetes, Endothelial function, Flow-mediated dilatation (FMD)

Medical Science, 2022, 26, ms344e2365

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DOI: https://doi.org/10.54905/disssi/v26i126/ms344e2365

Published: 27 August 2022