Comparison between the Effects of Hypertension on Diabetic Mellitus with Endothelin Function
DOI:
https://doi.org/10.32007/jfacmedbaghdad3180Keywords:
Diabetes Mellitus, Endothelin-1, Hypertension, Lipid profile, Vascular ComplicationsAbstract
both strongly associated with vascular and metabolic complications. Endothelin-1 is a potent vasoconstrictor that plays a key role in vascular tone regulation and endothelial function.
Objective: To evaluate serum Endothelin-1 levels, lipid profile parameters (total cholesterol, LDL-C, VLDL-C, HDL-C, triglycerides), and HbA1c in patients with type 2 diabetes and essential hypertension compared with healthy controls, in order to assess their association with vascular injury and metabolic risk.
Methods: A case-control study was conducted in the Department of Biochemistry, College of Medicine, University of Baghdad. Between November 2024 and February 2025, a sample of patients were recruited from Baghdad Teaching Hospital and Ibn Al-Bitar Center for Cardiac Surgery Hospital. A study on 180 adult males (aged 40–50 years), divided into three groups: 60 with type 2 diabetes mellitus (Group A), 60 with essential hypertension (Group B), and 60 healthy controls (Group C). Blood samples were collected after an overnight fast for measurement of HbA1c, lipid profile, and Endothelin-1 using a Sandwich-ELISA kit.
Results: Significant differences were observed among the three groups. Group A showed markedly higher HbA1c, triglycerides, and VLDL-C, along with significantly lower HDL-C compared with Groups B and C. Both Groups A and B had significantly elevated total cholesterol and LDL-C compared with controls. Endothelin-1 levels were significantly higher in diabetics than in hypertensive patients and controls.
Conclusion: Both diabetes and hypertension impair metabolic health, with diabetes showing more severe effects on lipid metabolism and glycemic control. Elevated endothelin-1 levels in diabetics may contribute to increased vascular risk, highlighting the need for early metabolic monitoring and intervention.
Received: July 2025
Revised: Dec. 2025
Accepted: Dec. 2025
Published Online: Dec. 2025
Published: Dec. 2025
Downloads
References
1. Ahmed HS, Mohammed MS. Atherogenic Indices in Type 2 Diabetic Iraqi Patients and Its Association with Cardiovascular Disease Risk. J Fac Med Baghdad [Internet]. 2023 Oct. 1;65(3):179-86. https://doi.org/10.32007/jfacmedbagdad.2075
2. Horton WB, Barrett EJ. Microvascular dysfunction in diabetes mellitus and cardiometabolic disease. Endocrine reviews. 2021;42(1):29-55. https://doi.org/10.1210/endrev/bnaa025
3. Krzemińska J, Wronka M, Młynarska E, Franczyk B, Rysz J. Arterial Hypertension—Oxidative Stress and Inflammation. Antioxidants. 2022 Jan 17;11(1):172. https://doi.org/10.3390/antiox11010172
4. Zaidan ZJ, Hussein AM, Ahmed SM. Study of Dyslipidemia in Iraqi Hypertension Patients in Tikrit City. MLU. 2020 Apr. 9 ;20(1):516-21. https://doi.org/10.37506/mlu.v20i1.411
5. Khaleefah MA, Al-Badri HJ, Mousa NA. Hypertension Control among Adult Iraqis. J Fac Med Baghdad. 2022 Oct. 17 ;64(3):145-52. https://doi.org/10.32007/jfacmedbagdad.6431935
6. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. Practice guidelines for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Blood Pressure. 2018 Oct 31;27(6):314–40. https://doi.org/10.1080/08037051.2018.1527177
7. Wautier JL, Wautier MP. Vascular Permeability in Diseases. Int J Mol Sci. 2022 Mar 26;23(7):3645. https://doi.org/10.3390/ijms23073645
8. Othman HK, Mahmud AMR, Maulood IM. The Roles of Potassium Channels and Nitric oxide in the Modulation of Apelin induced-relaxation in Isolated Diabetic Rat Aorta. Iraqi J Sci. 2024 Feb. 29;65(2):644-58. https://doi.org/10.24996/ijs.2024.65.2.6
9. Wang Y, Yang P, Yan Z, Liu Z, Ma Q, Zhang Z, et al. The relationship between erythrocytes and diabetes mellitus. Journal of Diabetes Research. 2021;2021(1):6656062. https://doi.org/10.1155/2021/6656062
10. Naseri MW, Esmat HA, Bahee MD. Prevalence of hypertension in Type-2 diabetes mellitus. Annals of Medicine and Surgery. 2022;78. https://doi.org/10.1016/j.amsu.2022.103758
11. Jeong HG, Park H. Metabolic disorders in menopause. Metabolites. 2022 Oct 8;12(10):954. https://doi.org/10.3390/metabo12100954
12. Feingold KR, Grunfeld C. Diabetes and dyslipidemia. In Diabetes and Cardiovascular Disease Cham: Springer International Publishing. 2023 Jun 2. 425-472. https://doi.org/10.1007/978-3-031-13177-6_14
13. Salameh AB, Hyassat D, Suhail A, Makahleh Z, Khader Y, El-Khateeb M, et al. The prevalence of hypertension and its progression among patients with type 2 diabetes in Jordan. Ann Med Surg. 2021; 73:103162. https://doi.org/10.1016/j.amsu.2021.103162
14. Li YW, Kao TW, Chang PK, Chen WL, Wu LW. Atherogenic index of plasma as predictors for metabolic syndrome, hypertension and diabetes mellitus in Taiwan citizens: a 9-year longitudinal study. Sci Rep. 2021;11(1):9900. Published 2021 May 10. https://doi.org/10.1038/s41598-021-89307-z.
15. Hu X, Liu Q, Guo X, Wang W, Yu B, Liang B, et al. The role of remnant cholesterol beyond low-density lipoprotein cholesterol in diabetes mellitus. Cardiovascular diabetology. 2022;21(1):117. https://doi.org/10.1186/s12933-022-01554-0.
16. Neligan PJ. Metabolic syndrome. Sinha AC, editor. Oxford Textbook of Anaesthesia for the Obese Patient. 2021 May; 77–84. https://doi.org/10.1093/med/9780198757146.003.0008
17. Wyszyńska J, Łuszczki E, Sobek G, Mazur A, Dereń K. Association and Risk Factors for Hypertension and
Dyslipidemia in Young Adults from Poland. Int J Environ Res Public Health. 2023;20(2):982. Published 2023 Jan 5. https://doi.org/10.3390/ijerph20020982
18. Kostov K. The causal relationship between endothelin-1 and hypertension: focusing on endothelial dysfunction, arterial stiffness, vascular remodeling, and blood pressure regulation. Life. 2021;11(9):986. https://doi.org/10.3390/life11090986.
19. Mayas F, Ibrahim K Ibdah R, Al-Kasasbeh A, Ababneh MJ, Ababneh AA, et al. Association of plasma endothelin-1 levels with revascularization strategies and short-term clinical outcomes: role of diabetes. Heliyon.2024 1;10(18): e37777–7. https://doi.org/10.1016/j.heliyon.2024.e37777
20. Muir RQ. Early Life Stress and Endothelin Receptor Type A: Separate Roles in Mediating Colitis [Internet]. UAB Digital Commons. 2023 Available from: https://digitalcommons.library.uab.edu/etd-collection/10/
21. Banecki KMRM, Dora KA. Endothelin 1 in Health and Disease. Int J Mol Sci. 2023;24(14):11295. ttps://doi.org/10.3390/ijms241411295
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2025 Haider K. Al-Haddad, Shifaa I. Jameel, Ameen A. Al-Alwany
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons Attribution 4.0 International license..
