Early Microvascular Dysfunction in Healthy Normal-Weight Males With Heredity for Type 2 Diabetes
- Gun Jörneskog, MD, PHD1,
- Majid Kalani, MD, PHD2,
- Jeanette Kuhl, MD3,
- Peter Båvenholm, MD, PHD4,
- Abram Katz, MD, PHD5,
- Gustaf Allerstrand, MD1,
- Michael Alvarsson, MD, PHD3,
- Suad Efendic, MD, PHD3,
- Claes-Göran Östenson, MD, PHD3,
- John Pernow, MD, PHD2,
- John Wahren, MD, PHD6 and
- Kerstin Brismar, MD, PHD3
- 1Department of Internal Medicine, Danderyd University Hospital, Karolinska Institute at Danderyd Hospital, Stockholm, Sweden
- 2Department of Cardiology, Karolinska University Hospital Solna, Karolinska Institute, Stockholm, Sweden
- 3Department of Endocrinology and Diabetology, Karolinska University Hospital Solna, Karolinska Institute, Stockholm, Sweden
- 4Department of Internal Medicine, Karolinska University Hospital Solna, Karolinska Institute, Stockholm, Sweden
- 5Department of Physiology and Pharmacology, Karolinska University Hospital Solna, Karolinska Institute, Stockholm, Sweden
- 6Department of Surgical Sciences, Karolinska University Hospital Solna, Karolinska Institute, Stockholm, Sweden
- Address correspondence and reprint requests to Gun Jörneskog, MD, PhD, Department of Internal Medicine, Danderyd University Hospital, S-18288 Stockholm, Sweden. E-mail: gun.jorneskog{at}ds.se
- Ach, acetylcholine
- CBV, capillary blood cell velocity
- FMD, flow-mediated vasodilatation
- SNP, sodium nitroprusside
The pathogenesis behind diabetic microangiopathy is complex; both genetic (1–3) and metabolic factors (4–6) are clearly of importance. Recently, it has been demonstrated that not only patients with diabetes but also healthy individuals at risk for diabetes have functional vascular disturbances (7). These findings suggest that factors other than hyperglycemia are of importance for microvascular dysfunction. The aim of the present study was to investigate whether genetic factors (heredity for type 2 diabetes) are associated with disturbances in nutritive skin capillary circulation, nonnutritive skin microcirculation, and/or brachial macrocirculation.
RESEARCH DESIGN AND METHODS
Subjects were from the Stockholm Diabetes Prevention Program, a population-based study (8). Normal-weight men who were free of medication, who were nonsmokers, and who had normal oral glucose tolerance tests and insulin sensitivity as assessed by a hyperinsulinemic-euglycemic clamp (9) were investigated. Ten men with heredity for type 2 diabetes were matched for age and BMI with 10 men without heredity. Heredity for type 2 diabetes was defined as known diabetes in at least two second-degree relatives (grandparent, uncle, or aunt) or in at least one first-degree relative in the generation of the proband (sister or brother) or the parents (8).
The investigations were performed in the …
