الفهرس 
STRUCTURE OF THE NORMAL ARTERYOnly 14 pages are availabe for public view
 |  | from | 196 |  |  |
| | | from | 196 | | |
Abstract
Type-II diabetes mellitus (DM) is characterized by increased oxidative stress as a result of the hyperglycaemic state, leading to decreased nitric oxide bioavailability (Calles-Escandon and Cipolla, 2001).
Similarly, type II DM is characterized by increased levels of proatherogenic cytokines and adhesion molecules (Calles-Escandon and Cipolla, 2001), While it has been shown that the endogenous endothelial nitric oxide synthase inhibitor, asymmetrical dimethyl arginine (ADMA), is also elevated in type II DM (Lin et al., 2002).
Although ADMA synthesis is triggered by both oxidative stress and proinflammatory stimuli, the effect of antioxidant or anti-inflammatory treatment on its release is unclear.
In this study, we have compared the effects of atorvastatin (which has anti-inflammatory properties in atherosclerosis) and vitamin C (a well-known antioxidant) on the endothelial function in normocholesterolaemic patients with type-II DM.
Our aim in the present study was to compare the effect of atorvastatin to the effect of vitamin-C on the endothelial function aiming to find a substitute of atorvastatin with minimal side effects and less financial load on the patient.
Ninety patients with type-II DM were enrolled in the study. They were randomized into 3 groups; ator group, vitamin-C group and control group. Each group included 30 patients.
Every patient subjected to High resolution ultrasound (with frequency 7-12MHz) for assessment of endothelium dependent flow mediated vasodilation (FMD). The brachial artery was imaged above the antecubital fossa then the brachial artery diameter (BAD) and the brachial artery blood flow (BAF) were estimated basally (BADbasal and BAFbasal) and after 5 minutes of ischemia (BADmax and BAFmax) (by inflating the cuff 50mmHg above the systolic BP). The percentage of change was taken as an indicator for the endothelial function {(BADmax -BADbasal) ÷ BADbasal} × 100.
After 4 weeks of taking atorvastatin in group 1, vitamin C in group 2 and no treatment in group 3; assessment of endothelium dependent flow mediated vasodilation was repeated.
The present study found that the improvement in the percentage of change in BAD in atorvastatin group was statistically significant (range was 0.568-22.314 with a median of 7.726 before treatment VS a range of 4.887-37.165 with a median of 18.288 after ator treatment and the P-value was 0.001) (P-value of control group 0.504).
While the in vitamin-C group the range was
(-1.602 -25.501) with a median of 13.785 which has turned after 4 weeks of vitamin-C treatment to show a range of (0.475-22.647) with a median of 13.119 and a P-value of 0.051 (P-value of control group 0.504).