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Diabetologia
Published in: Diabetologia 11/2005

01-11-2005 | Article

Differences in the association between type 2 diabetes and impaired microvascular function among Europeans and African Caribbeans

Authors: W. D. Strain, N. Chaturvedi, P. Nihoyannopoulos, C. J. Bulpitt, C. Rajkumar, A. C. Shore

Published in: Diabetologia | Issue 11/2005

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Abstract

Aims/hypothesis

Diabetes is associated with microvascular damage in all populations, but diabetic patients of Black African descent (African Caribbeans) have a greater risk of vascular target organ damage than would be anticipated for any given blood pressure level. We investigated whether this may be due to differences in the microvasculature.

Materials and methods

To assess the maximum hyperaemic response to heating and the post-ischaemic response, Laser Doppler fluximetry was performed on 51 and 100 Europeans, and on 66 and 88 African Caribbeans with and without diabetes, respectively. Subjects were aged between 40 and 65 years and recruited from the general population. Echocardiographic interventricular septal thickness (IVST) was measured as a proxy for vascular target organ damage.

Results

In diabetic subjects of both ethnic groups, the maximum hyperaemic response and peak response to ischaemia were attenuated as compared to the corresponding non-diabetic subjects (p=0.08 for diabetic and 0.03 for non-diabetic Europeans; p=0.03 and 0.1 for African Caribbeans). Adjustment for cardiovascular risk factors, in particular insulin and blood pressure, abolished these differences in Europeans (p=0.8 for diabetic and 0.2 for non-diabetic Europeans), but not in African Caribbeans (p=0.03 and 0.05).

Conclusions/interpretation

Persisting microvascular dysfunction in African Caribbeans may contribute to the increased risk of target organ damage observed in diabetes in this population. The weak contribution of conventional cardiovascular risk factors to these disturbances indicates that conventional therapeutic interventions may be less beneficial in these patients. There was a risk-factor-independent, inverse association between IVST and maximal hyperaemia. These ethnic differences in microvascular responses to temperature and arterial occlusion could account for increased target organ damage in African Caribbeans.
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Metadata
Title
Differences in the association between type 2 diabetes and impaired microvascular function among Europeans and African Caribbeans
Authors
W. D. Strain
N. Chaturvedi
P. Nihoyannopoulos
C. J. Bulpitt
C. Rajkumar
A. C. Shore
Publication date
01-11-2005
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 11/2005
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-005-1950-9

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