The aim was to study endothelial function (EF) and the arterial wall (AW) stiffness in patients with DM and LI.

Methods: Nine patients with DM and LI as defined by clinical characteristics and MRI findings were compared with 35 age and gender-matched patients with LI without DM. EF was assessed using the brachial flow-mediated vasodilatation (FMD) on the first day after stroke onset in both groups. Carotid stiffness index ß was calculated as follows: ln(systolic/diastolic blood pressure)/([Dmax-Dmin]/Dmin), where Dmax/Dmin are maximum and minimum common carotid lumen diameters measured by carotid ultrasound. Carotid intima-media thickness (IMT) was also measured. FMD was categorized according to ROC analysis and ED was defined as FMD ≤6.0%.

Results: Eight patients (89%) in the first group and twenty-two (63%) in the second had ED (p=0.006). Seven patients (78%) in the first group and none in the second had a distinctive feature – the presence of the additional hyperechogenic layer in the AW. Carotid stiffness was higher in first group (17.3±3.4 versus 10.5±2.2, p=0.04), while FMD was lower (3.4±1.5% versus 6.1±2.5%, p=0.03). There was no significant difference in IMT between two groups (0.95±0.15 in the first group versus 0.91±0.17). Moderate correlation was observed between stiffness and IMT (r=0.33, p=0.01). No correlations were found between FMD and IMT, FMD and stiffness.

Conclusion: Patients with DM and LI are characterized by the marked impairment of the structural-and-functional properties of the AW and they have a distinctive feature (additional hyperechogenic layer in the AW). The IMT thickening influences the arterial stiffness.