VASOACTIVE FACTORS OF VASCULAR ENDOTHELIU M IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS WITH RENAL LESIONS

To evaluate the secretion of vasoactive factors in vascular endotheliu m of patients with non-insulin-dependent diabetes mellitus (NIDDM) the authors examined 31 NIDDM patients. Of them, 18 had no signs of renal involvement, 13 patients showed apparent diabetic nephropathy (DN). I n the former patients the blood contained much greater content of vaso dilating factor prostacyclin than of vasoconstricting factor endotheli n-1 (ET-1) and thromboxan A2 (TxA2). In diabetic nephropathy the balan ce of vasoactive factors shifted to predominance of vasoconstrictors E T-1 and TxA2. Such rearrangement of vasoactive factors to higher quant ities of vasoconstrictors in diabetes mellitus may initiate or promote progression of diabetic nephropathy with resultant spasm of afferent glomerular vessels, reduced glomerular filtration and renal blood flow rates, arterial hypertension, increased thrombogenesis. Thus, elevate d levels of ET-1 and TxA2 in diabetics and their rise with progression of diabetic nephropathy are likely to act as pathogenetic factors und erlying onset and progression of nephroangiopathy.