Vascular endothelium and inflammatory process, in patients with combined Type 2 diabetes mellitus and coronary atherosclerosis: the effects of vitamin C

  1. C. Antoniades1,
  2. D. Tousoulis1,*,
  3. C. Tountas2,
  4. C. Tentolouris1,
  5. M. Toutouza1,
  6. C. Vasiliadou1,
  7. C. Tsioufis1,
  8. P. Toutouzas1,
  9. C. Stefanadis1

Article first published online: 19 MAY 2004

DOI: 10.1111/j.1464-5491.2004.01201.x

Issue

Diabetic Medicine

Diabetic Medicine

Volume 21, Issue 6, pages 552–558, June 2004

Additional Information

How to Cite

Antoniades, C., Tousoulis, D., Tountas, C., Tentolouris, C., Toutouza, M., Vasiliadou, C., Tsioufis, C., Toutouzas, P. and Stefanadis, C. (2004), Vascular endothelium and inflammatory process, in patients with combined Type 2 diabetes mellitus and coronary atherosclerosis: the effects of vitamin C. Diabetic Medicine, 21: 552–558. doi: 10.1111/j.1464-5491.2004.01201.x

Author Information

  1. 1

    Cardiology Department, Athens University Medical School

  2. 2

    Department of Diabetology, Hippokration Hospital, Athens, Greece

*Dimitris Tousoulis MD PhD FACC, S Karagiorga 69, Glifada, 166 75, Athens, Greece. E-mail: tousouli@med.uoa.gr

Publication History

  1. Issue published online: 19 MAY 2004
  2. Article first published online: 19 MAY 2004
  3. Accepted 15 September 2003

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (128K)

Keywords:

  • adhesion molecules;
  • endothelium;
  • oxidative stress;
  • pro-inflammatory cytokines;
  • vitamin C

Abstract

Aims  Type 2 diabetes mellitus (DM) and coronary artery disease (CAD) are both associated with endothelial dysfunction and elevated oxidative and inflammatory state. We examined the effect of vitamin C on endothelial function and levels of soluble vascular cell adhesion molecule (sVCAM-1), interleukin-6 (IL-6) and tumour necrosis factor (TNF-α), in DM patients with or without CAD and in non-diabetic subjects.

Methods  Thirty-seven patients with DM + CAD, 17 patients with DM without CAD and 21 non-diabetic subjects were divided into groups receiving vitamin C 2 g/day or no anti-oxidant for 4 weeks. Forearm blood flow was determined using venous occlusion gauge-strain plethysmography. Forearm vasodilatory response to reactive hyperemia was considered as index of endothelium-dependent dilation.

Results  Baseline levels of IL-6 and TNF-α were significantly higher in patients with DM + CAD compared with patients with DM (P < 0.01) or non-diabetic subjects (P < 0.01). IL-6 and TNF-α levels were also higher in DM compared with non-diabetic subjects (P < 0.05). sVCAM-1 levels were lower in non-diabetic controls compared with DM + CAD (P < 0.05) or DM (P < 0.05). Reactive hyperaemia was higher in non-diabetic controls compared with DM + CAD (P < 0.001) or DM (P < 0.001). Vitamin C significantly increased reactive hyperaemia only in the DM + CAD group, while it had no effect on serum levels of sVCAM-1, TNF-α and IL-6 in any of the groups.

Conclusions  Type 2 diabetes mellitus is associated with impaired endothelial function and increased levels of TNF-α, IL-6 and sVCAM-1, especially in patients with DM and CAD. Vitamin C significantly increased forearm vasodilatory response to reactive hyperaemia only in patients with combined DM and CAD.

View Full Article (HTML) Get PDF (128K)