Evaluation of flow-mediated dilatation (FMD)
The FMD evaluation was made in each participant in early morning after
overnight fasting period in a standard ultrasound room by expert
sonographer before starting other steps of study (blood sampling) as
described in previous literature 8,9 . An android
compatible linear transducer (Philips Lumify L12-4 [12–4 mHz];
Philips Ultrasound Inc., Bothell, WA) was used to evaluation of vessel
diameter. The normal diameter of the brachial artery was measured over
about 5 cm of the antecubital fossa and therefore the evaluation point
was marked. Thereafter the sphygmomanometer cuff was placed to proximal
site of evaluation point and inflated to above 50 mmHg of normal blood
pressure for five minutes as explained in previous literature8,9 . After 5 minutes of ischemia period cuff was
deflated and the ultrasound probe was placed to marked point for
measurement of post-ischemic diameter of brachial artery. The
enlargement of diameter equal or over than 5% was accepted as normal
response and lower than 5% was accepted as abnormal vascular response
to ischemia which indicates abnormal endothelial function8,9 .