The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling: The Maastricht Study

被引：21

作者：

Foreman, Yuri D. ^{[1
,2
]}

Brouwers, Martijn C. G. J. ^{[2
,3
]}

Berendschot, Tos T. J. M. ^{[4
]}

van Dongen, Martien C. J. M. ^{[5
,6
]}

Eussen, Simone J. P. M. ^{[2
,5
]}

van Greevenbroek, Marleen M. J. ^{[1
,2
]}

Henry, Ronald M. A. ^{[1
,2
,7
]}

Houben, Alfons J. H. M. ^{[1
,2
]}

van der Kallen, Carla J. H. ^{[1
,2
]}

Kroon, Abraham A. ^{[1
,2
,7
]}

Reesink, Koen D. ^{[2
,7
,8
]}

Schram, Miranda T. ^{[1
,2
,7
]}

Schaper, Nicolaas C. ^{[2
,3
,6
]}

Stehouwer, Coen D. A. ^{[1
,2
]}

机构：

[1] Maastricht Univ, Dept Internal Med, Med Ctr, Maastricht, Netherlands

[2] Maastricht Univ, CARIM Sch Cardiovasc Dis, Maastricht, Netherlands

[3] Maastricht Univ, Dept Internal Med, Div Endocrinol & Metab Dis, Med Ctr, Maastricht, Netherlands

[4] Maastricht Univ, Med Ctr, Univ Eye Clin Maastricht, Maastricht, Netherlands

[5] Maastricht Univ, Dept Epidemiol, Maastricht, Netherlands

[6] Maastricht Univ, CAPHRI Care & Publ Hlth Res Inst, Maastricht, Netherlands

[7] Maastricht Univ, Med Ctr, Heart & Vasc Ctr, Maastricht, Netherlands

[8] Maastricht Univ, Dept Biomed Engn, Maastricht, Netherlands

来源：

CARDIOVASCULAR DIABETOLOGY | 2019年 / 18卷 / 01期

关键词：

Arterial remodeling; Arterial stiffness; Glucose metabolism status; Glucose variability; Oral glucose tolerance test; INTIMA-MEDIA THICKNESS; GLYCEMIC VARIABILITY; MICROVASCULAR DYSFUNCTION; OXIDATIVE STRESS; TYPE-2; HYPERGLYCEMIA; POPULATION; RISK; COMPLICATIONS; INDIVIDUALS;

D O I：

10.1186/s12933-019-0950-x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Daily glucose variability may contribute to vascular complication development irrespective of mean glucose values. The incremental glucose peak (IGP) during an oral glucose tolerance test (OGTT) can be used as a proxy of glucose variability. We investigated the association of IGP with arterial stiffness, arterial remodeling, and microvascular function, independent of HbA(1c) and other confounders. Methods IGP was calculated as the peak minus baseline plasma glucose value during a seven-point OGTT in 2758 participants (age: 60 +/- 8 years; 48% women) of The Maastricht Study, an observational population-based cohort. We assessed the cross-sectional associations between IGP and arterial stiffness (carotid-femoral pulse wave velocity [cf-PWV], carotid distensibility coefficient [carDC]), arterial remodeling (carotid intima-media thickness [cIMT]; mean [CWSmean] and pulsatile [CWSpuls] circumferential wall stress), and microvascular function (retinal arteriolar average dilatation; heat-induced skin hyperemia) via multiple linear regression with adjustment for age, sex, HbA(1c), cardiovascular risk factors, lifestyle factors, and medication use. Results Higher IGP was independently associated with higher cf-PWV (regression coefficient [B]: 0.054 m/s [0.020; 0.089]) and with higher CWSmean (B: 0.227 kPa [0.008; 0.446]). IGP was not independently associated with carDC (B: - 0.026 10(-3)/kPa [- 0.112; 0.060]), cIMT (B: - 2.745 mu m [- 5.736; 0.245]), CWSpuls (B: 0.108 kPa [- 0.054; 0.270]), retinal arteriolar average dilatation (B: - 0.022% [- 0.087; 0.043]), or heat-induced skin hyperemia (B: - 1.380% [- 22.273; 19.513]). Conclusions IGP was independently associated with aortic stiffness and maladaptive carotid remodeling, but not with carotid stiffness, cIMT, and microvascular function measures. Future studies should investigate whether glucose variability is associated with cardiovascular disease.

引用

页数：12