Dorothy Liu , Sara Baqar, Lisa L. Lincz and Elif I. Ekinci* Pages 435 - 445 ( 11 )
There is ongoing debate surrounding the complex relationship between dietary sodium intake and cardiovascular morbidity and mortality. The existing literature consists largely of observational studies that have demonstrated positive, negative, U-/J-shaped or unclear associations between sodium intake and cardiovascular outcomes. Our group and others have previously demonstrated an inverse relationship between dietary sodium intake and cardiovascular outcomes in people with type 2 diabetes. Increased activity of the renin-angiotensin-aldosterone system and sympathetic nervous system is postulated to contribute to these paradoxical findings through endothelial dysfunction, a precursor to the development of cardiovascular disease. Microvesicles are submicron (0.1 – 1.0μm) vesicles that form during cellular activation, injury or death with endothelial microvesicles being recognized markers of endothelial dysfunction. They are pathologically elevated in a variety of vascular-related conditions including type 2 diabetes. Lower habitual sodium intake in type 2 diabetes has been associated with higher pro-coagulant platelet microvesicles levels but not with endothelial microvesicles. Research utilizing endothelial microvesicles to evaluate the mechanistic relationship between dietary sodium intake and adverse cardiovascular outcomes in type 2 diabetes remains scarce.
Cardiovascular disease, endothelial dysfunction, endothelial microvesicles, sodium intake, twenty four hour urinary sodium excretion, type 2 diabetes.
Department of Medicine, Austin Health, Heidelberg, Victoria, Department of Medicine, Austin Health, Heidelberg, Victoria, Hunter Haematology Research Group, Calvary Mater Newcastle, New South Wales, Department of Medicine, Austin Health, Heidelberg, Victoria