Allopurinol and Nitric Oxide Activity in the Cerebral Circulation of those with Diabetes; a Randomised Trial
- Jesse Dawson, MRCP (j.dawson{at}clinmed.gla.ac.uk)1,
- Terry Quinn, MRCP1,
- Craig Harrow, MRCP1,
- Kennedy R Lees, MD, FRCP1,
- Christopher J Weir, PhD2,
- Stephen J Cleland, PhD, FRCP3 and
- Matthew R Walters, MD, FRCP1
- 1 Acute Stroke Unit, Division of Cardiovascular and Medical Sciences, University of Glasgow, Western Infirmary, Glasgow, G11 6NT
- 2 Robertson Centre for Biostatistics, University of Glasgow, University Avenue, Glasgow, G12 8QQ
- 3 Stobhill Hospital, 133 Balornock Road, Glasgow G21 3UT
Abstract
Objective: Type 2 diabetes conveys an increased risk of stroke, perhaps because of impaired cerebrovascular basal nitric oxide (NO) activity. We investigated whether this is improved by a 2 week course of the xanthine oxidase inhibitor allopurinol.
Methods: We performed a randomised, double blind, placebo controlled crossover study. We measured the response to infusion of L-NMMA in males with type 2 diabetes before and after allopurinol/placebo. The primary endpoint was the change in internal carotid artery (ICA) flow following L-NMMA infusion, expressed as the area under the flow/time curve.
Results: We enrolled 14 participants. Allopurinol improved response to L-NMMA when compared to placebo (p=0.032, median reduction in ICA flow reduction following L-NMMA of 3144 [95% CI 375 to 7143] mls).
Conclusion: Xanthine oxidase inhibition with allopurinol appears to improve cerebral NO bioavailability as evidenced by a greater response to infusion of L-NMMA.
Footnotes
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- Received July 14, 2008.
- Accepted October 15, 2008.
- Copyright © American Diabetes Association
