Impaired vascular relaxation in type 2 diabetes

A systematic review and meta-analysis

Authors

  • Sajad Jeddi Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0002-3911-6620
  • Zahra Bahadoran Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0003-4636-3977
  • Parvin Mirmiran Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0003-2391-4924
  • Khosrow Kashfi Department of Molecular, Cellular, and Biomedical Sciences, Sophie Davis School of Biomedical Education, City University of New York School of Medicine, NY, USA NY, 10031, USA. E-mail: Kashfi@med.cuny.edu https://orcid.org/0000-0002-4060-7283
  • Asghar Ghasemi Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: Ghasemi@sbmu.ac.ir https://orcid.org/0000-0001-6867-2151

DOI:

https://doi.org/10.17179/excli2024-7330

Keywords:

Type 2 diabetes, vascular complications, vascular smooth muscle, acetylcholine, methacholine, sodium nitroprusside, glyceryl trinitrate

Abstract

Type 2 diabetes (T2D) significantly increases the risk of vascular complications (12-32 %), which are a major cause of death (over 50 %) in T2D patients. In T2D, both endothelial (ET) and vascular smooth muscle (VSM) cells are impaired, which act as independent risk factors for cardiovascular disease. Thus, the question of this systematic review and meta-analysis is: Do ET-dependent and -independent VSM relaxation impair in T2D? We systematically searched PubMed and Scopus databases until March 2024; 44 eligible clinical trial studies (68, 16, 30, and 50 study arms for acetylcholine (ACh), methacholine (MTH), sodium nitroprusside (SNP), and glyceryl trinitrate (GTN)) published were included. ET-dependent VSM relaxation in response to ACh (overall ES = -28.9 %, 95 % CI: -35.2, -22.7; p<0.001) and MTH (overall ES = -55.3 %, 95 % CI: -63.6, -47.1; p<0.001) decreased in T2D patients compared to controls. ET-independent VSM relaxation in response to SNP (overall ES = -17.2 %, 95 % CI: -35.2, -22.7; p<0.001) and GTN (overall ES = -63.2 %, 95 % CI: -81.0, -45.5; p<0.001) decreased in T2D patients compared to controls. Our meta-analysis showed reductions in both ET-dependent (~40 %) and ET-independent (~25 %) VSM relaxation. The decrease was more pronounced for MTH (~55 %) compared to ACh (~30 %) and for GTN (~63 %) compared to SNP (~17 %). These findings suggest that dysfunction of both ET and VSM contributes to impaired VSM relaxation in T2D patients.

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Published

2024-07-09

How to Cite

Jeddi, S., Bahadoran, Z., Mirmiran, P., Kashfi, K., & Ghasemi, A. (2024). Impaired vascular relaxation in type 2 diabetes: A systematic review and meta-analysis. EXCLI Journal, 23, 937–959. https://doi.org/10.17179/excli2024-7330

Issue

Vol. 23 (2024)

Section

Review articles

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Copyright (c) 2024 Sajad Jeddi, Zahra Bahadoran, Parvin Mirmiran, Khosrow Kashfi, Asghar Ghasemi

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