Titre du document / Document title

Blood letting in high-ferritin type 2 diabetes: Effects on vascular reactivity

Auteur(s) / Author(s)

FERNANDEZ-REAL José Manuel ⁽¹⁾ ; PENARROJA Georgina ⁽²⁾ ; CASTRO Antoni ⁽²⁾ ; GARCIA-BRAGADO Fernando ⁽²⁾ ; LOPEZ-BERMEJO Abel ⁽¹⁾ ; RICART Wifredo ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Unit of Diabetes, Endocrinology and Nutrition, University Hospital of Girona Dr Josep Trueta, Girona, ESPAGNE
⁽²⁾ Department of Internal Medicine, University Hospital of Girona Dr Josep Trueta, Girona, ESPAGNE

Résumé / Abstract

OBJECTIVE-In a recent study, iron chelation with deferoxamine led to improvement of endothelial dysfunction in patients with coronary artery disease. We tested the hypothesis that decreasing circulating iron stores might improve vascular dysfunction in patients with type 2 diabetes and increased serum ferritin concentration. RESEARCH DESIGN AND METHODS-A total of 28 type 2 diabetic male patients with serum ferritin levels >200 ng/ml (∼18% of consecutive type 2 diabetic men attending our outpatient clinic) were randomized to iron depletion (three extractions of 500 ml blood at 2-week intervals; group lA) or to observation (group 1B). C282Y mutation was absent in all patients. Vascular reactivity (high-resolution external ultrasound) was evaluated at baseline and at 4 and 12 months thereafter. The two groups of patients were matched for age, BMI, pharmacological treatment, and chronic diabetic complications. RESULTS-Endothelium-dependent vasodilation remained essentially unchanged in both groups of patients In contrast, the vasodilation induced by glyceryl trinitrate (GTN) improved significantly after iron depletion (P = 0.006). These changes occurred in parallel to decreases in transferrin saturation index and HbA_1c levels (-0.6%, P < 0.05) only in group 1A patients. The best predictor of the modifications in endothelium-independent vasodilation was the change in HbA_1c levels. Changes in endothelium-independent vasodilation also correlated with the change in serum ferritin (r = -0.45, P = 0.04). At 12 months, transferrin saturation index and GTN-induced vasodilation returned to values similar to those at baseline in both groups of subjects. CONCLUSIONS-Iron depletion improves vascular dysfunction in type 2 diabetic patients with high ferritin concentrations. The mechanisms by which these changes occur should he further investigated.

Revue / Journal Title

Diabetes care   ISSN 0149-5992   CODEN DICAD2 

Source / Source

2002, vol. 25, n^o12, pp. 2249-2255 [7 page(s) (article)] (51 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Diabetes Association, Alexandria, VA, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Vascular disease ; Cardiovascular disease ; Endocrinopathy ; Hemoglobin A1c ; Predictive factor ; Vasodilation ; Randomization ; Blood ; Depletion ; Ferritin ; Atherosclerosis ; Experimental study ; Human ; Non insulin dependent diabetes ;

Mots-clés français / French Keywords

Vaisseau sanguin pathologie ; Appareil circulatoire pathologie ; Endocrinopathie ; Hémoglobine A1c ; Facteur prédictif ; Vasodilatation ; Randomisation ; Sang ; Déplétion ; Ferritine ; Athérosclérose ; Etude expérimentale ; Homme ; Diabète non insulinodépendant ;

Mots-clés espagnols / Spanish Keywords

Vaso sanguíneo patología ; Aparato circulatorio patología ; Endocrinopatía ; Hemoglobina A1c ; Factor predictivo ; Vasodilatación ; Aleatorización ; Sangre ; Depleción ; Ferritina ; Ateroesclerosis ; Estudio experimental ; Hombre ; Diabetes no insulinodependiente ;

Localisation / Location

INIST-CNRS, Cote INIST : 18054, 35400010549872.0220