Functional Tests for Improving the Effectiveness of Ultrasound Dopplerography of Microvascular Vessels in Diagnosing of Endothelial Function in Type 2 Diabetes Mellitus
Z. L. Malakhova,
N. B. Margaryants,
A. V. Tishkov,
A. V. Murasheva,
O. A. Lazovskaya,
O. V. Lukina,
T. D. Vlasov https://doi.org/10.24884/1682-6655-2025-24-3-50-56
Abstract
Introduction. Researches in recent decades have proved the importance of the endothelium role in regulating vascular tone in various pathologies and have significantly changed the perception of it, having shown its key role in the pathogenesis of a number of systemic pathologies such as diabetes mellitus, atherosclerosis, hypertension and many others. Aim. To compare the diagnostic significance of ultrasound dopplerography of microcirculatory vessels (MCV) using 2 stress tests: iontophoresis and occlusion test in patients with type 2 diabetes mellitus and a control group.
Materials and methods. Patients with type 2 diabetes and control groups were performed functional tests: occlusion test and ionophoresis of acetylcholine solution, with assessment of microcirculatory vascular response by ultrasound dopplerography.
Results. Patients in the type 2 diabetes group had altered response dynamics to vascular occlusion, with significant differences in the degree of increase in blood flow indicators in the MCV in response to the occlusion test were observed as early as 2 minutes after cuff deflation (p<0.001), and in the group with acetylcholine iontophoresis, 4 minutes after iontophoresis (p<0.001).
Conclusion. Both techniques proved to be accurate in diagnosing endothelial dysfunction in patients with type 2 diabetes mellitus, and demonstrated high reproducibility.
About the Authors
Z. L. Malakhova
Pavlov University
Russian Federation
Russian Federation
Malakhova Zinaida L. – Sonographer, Department of Ultrasound Diagnostics
6-8, L’va Tolstogo str., Saint Petersburg, 197022
N. B. Margaryants
Pavlov University
Russian Federation
Russian Federation
Margaryants Nikita B. – Candidate (PhD) of Technical Sciences, Associate Professor, Department of Physics, Mathematics and Informatics
6-8, L’va Tolstogo str., Saint Petersburg, 197022
A. V. Tishkov
Pavlov University
Russian Federation
Russian Federation
Tishkov Artem V. – Candidate (PhD) of Physical and Mathematical Sciences, Associate Professor, Head, Department of Physics, Mathematics, and Informatics
6-8, L’va Tolstogo str., Saint Petersburg, 197022
A. V. Murasheva
Pavlov University; Almazov National Medical Research Centre
Russian Federation
Russian Federation
Murasheva Anna V. – Candidate (PhD) of Medical Sciences, Senior Researcher
6-8, L’va Tolstogo str., Saint Petersburg, 197022
2, Akkuratova str., Saint Petersburg, 197341
O. A. Lazovskaya
Pavlov University
Russian Federation
Russian Federation
Lazovskaya Olga A. – Assistant Lecturer, GP (Family Medicine) Department
6-8, L’va Tolstogo str., Saint Petersburg, 197022
O. V. Lukina
Pavlov University
Russian Federation
Russian Federation
Lukina Olga V. – MD, Associate Professor, Acting Head, Radiology and Radiation Medicine Department
6-8, L’va Tolstogo str., Saint Petersburg, 197022
T. D. Vlasov
Pavlov University
Russian Federation
Russian Federation
Vlasov Timur D. – Dr. of Sci. (Med.), Professor, Head, Department of Pathophysiology
6-8, L’va Tolstogo str., Saint Petersburg, 197022
References
1. Pokrovskaya EV, Shestakova EA, Shestakova MV. Endothelial dysfunction in individuals with obesity in the presence and absence of type 2 diabetes mellitus: assessment of specific markers. Diabetes Mellitus. 2023;26(5):439-445. (In Russ.). https://doi.org/10.14341/DM13088.
2. Babik B, Peták F, Agócs S, Blaskovics I, Alács E, Bodó K, et al. Diabetes mellitus: endothelial dysfunction and changes in hemostasis. // Orv Hetil. 2018;159(33):1335-1345. (In Hung.). https://doi.org/10.1556/650.2018.31130.
3. Capellini VK, Celotto AC, Baldo CF, Olivon VC, Viaro F, Rodrigues AJ, et al. Diabetes and vascular disease: basic concepts of nitric oxide physiology, endothelial dysfunction, oxidative stress and therapeutic possibilities. Curr Vasc Pharmacol. 2010;8(4):526-544. https://doi.org/10.2174/157016110791330834.
4. Clyne AM. Endothelial response to glucose: dysfunction, metabolism, and transport // Biochem Soc Trans. 2021;49(1): 313-325. https://doi.org/10.1042/BST20200611.
5. De Vriese AS, Verbeuren TJ, Van de Voorde J, Lameire NH, Vanhoutte PM. Endothelial dysfunction in diabetes. Br J Pharmacol. 2000;130(5):963-974. https://doi.org/10.1038/sj.bjp.0703393.
6. Marfella R, Sardu C, Balestrieri ML, Siniscalchi M, Minicucci F, Signoriello G, et al. Effects of incretin treatment on cardiovascular outcomes in diabetic STEMI-patients with culprit obstructive and multivessel non obstructive-coronarystenosis. Diabetology & Metabolic Syndrome. 2018;10:1-11. https://doi.org/10.1186/s13098-017-0304-3.
7. Gero D. Hyperglycemia-induced endothelial dysfunction. In book: Endothelial dysfunction - old concepts and new challenges / ed. by Lenasi H. London: Intechopen, 2018. P. 179-210. https://doi.org/10.5772/intechopen.71433.
8. Kaur R, Kaur M, Singh J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies. Cardiovasc Diabetol. 2023;17(1): 121. https://doi.org/10.1186/s12933-018-0763-3.
9. Shi Y, Vanhoutte PM. Macro- and microvascular endothelial dysfunction in diabetes. J Diabetes. 2017;9(5): 434-449. https://doi.org/10.1111/1753-0407.12521.
10. Vlasov TD, Petrischev NN, Lazovskaya OA. Endothelial dysfunction. Do we understand this term properly? Messenger of Anesthesiology and Resuscitation. 2020;17(2):76-84. (In Russ.). https://doi.org/10.21292/2078-5658-2020-17-2-76-84.
11. Malakhova ZL, Amosov VI, Vlasov TD. Pros and cons of flow-dependent vasodilation of the brachial artery. Clinical Pathophysiology. 2024;30(S2):78. (In Russ.). https://doi.org/10.13140/RG.2.1.2076.0804.
12. Khripun IA, Morgunov MN, Vorobiev SV, et al. A new criterion for the early diagnosis of endothelial dysfunction in men. Clinical Medicine. 2017;95(7):642-647. (In Russ.). https://doi.org/10.18821/0023-2149-2017-95-7-642-647.
13. Corretti MC, Anderson TJ, Benjamin EJ, Celermajer DS, Charbonneau F, Creager MA, et al. Guidelines for the ultrasound assessment of endothelial-dependent flowmediated vasodilation of the brachial artery. J Am Coll Cardiol. 2002:39(2):257-265. https://doi.org/10.1016/s0735-1097(01)01746-6.
14. Creager MA, Lüscher TF, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part I. Circulation. 2003;108(12): 1527-1532. https://doi.org/10.1161/01.CIR.0000091257.27563.32.
15. Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 200;54(6):1615-1625. https://doi.org/10.2337/diabetes.54.6.1615.
16. Kim JA, Montagnani M, Koh KK, Quon MJ. Reciprocal relationships between insulin resistance and endothelial dysfunction. Circulation. 2006;113(15):1888-1904. https://doi.org/10.1161/CIRCULATIONAHA.105.563213.
17. Muniyappa R, Montagnani M, Koh KK, Quon MJ. Cardiovascular actions of insulin. Endocr Rev. 2007;28(5):463-491. https://doi.org/10.1210/er.2007-0006.
18. R Core Team. R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing, 2024. https://www.R-project.org/.
19. Lopez-Raton M, Rodriguez-Alvarez MX, Cadarso-Suarez C, Gude-Sampedro F. OptimalCutpoints: An R Package for Selecting Optimal Cutpoints in Diagnostic Tests. J Stat Softw. 2014:61(8):1-36. https://doi.org/10.18637/jss.v061.i08.
20. Sawilowsky SS. New effect size rules of thumb. J Mod Appl Stat Methods. 2009;8(2):597-599. https://doi.org/10.22237/jmasm/1257035100.
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For citations:
Malakhova Z.L., Margaryants N.B., Tishkov A.V., Murasheva A.V., Lazovskaya O.A., Lukina O.V., Vlasov T.D. Functional Tests for Improving the Effectiveness of Ultrasound Dopplerography of Microvascular Vessels in Diagnosing of Endothelial Function in Type 2 Diabetes Mellitus. Regional blood circulation and microcirculation. 2025;24(3):50-56. (In Russ.) https://doi.org/10.24884/1682-6655-2025-24-3-50-56
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