Acute Hyperglycemia Rapidly Suppresses Endothelium-dependent Arterial Dilation in First-degree Relatives of Type 2 Diabetic Patients

Abstract

Objective: Previous studies showed that endothelium-dependent arterial dilation is impaired in first-degree relatives of type 2 diabetes in the fasting state. In the present study, we examined whether endothelial dysfunction occurs when acute hyperglycemia is induced by oral glucose loading in this cohort.

Patients and Methods: This study included 32 normal glucose tolerant subjects. Of them, 17 with a family history (FH) of type 2 diabetic parents (FH+) and 15 with no first-degree relative with diabetes or coronary artery disease (FH-). The examination of vascular function was performed in fasting state and repeated 1 and 2 hours after a 75-g oral glucose loading by high resolution ultrasound.

Results: Endothelium- dependent arterial dilation in FH+ group were significantly lower than those in FH- before and after oral glucose loading (5.12±0.61% vs 6.03±0.56%, fasting; 4.0±0.65% vs 5.70±0.42%, 1 h; 4.43±0.61% vs 5.82±0.67% 2 h, p<0.05 each). In FH+ group, endothelium-dependent arterial dilation decreased significantly at 60 min (4.0±0.65% vs 5.12±0.61%, p<0.01) and increased markedly from 60 min at 120 min (4.43±0.61% vs 4.0±0.65%, p<0.05), which was still significantly lower than baseline (4.43±0.61% vs 5.12±0.61%, p<0.01) . In FH- group, however, the arterial dilation did not differ significantly among the three time points (p 0.05). In multiple regression analysis, endothelium-dependent arterial dilation was significantly correlated to FH+(r=-0.302, p<0.01). In addition, endothelium-dependent arterial dilation showed a correlation with plasma glucose (r=-0.460, p<0.01) and TBARS (r=-0.382, p<0.01) during OGTT in FH+ subjects.

Conclusion: Significant endothelial dysfunction is present in the fasting state, hyperglycemia in response to oral glucose loading rapidly suppresses endothelium-dependent arterial dilation in FH+ subjects, probably through increased production of oxygen-derived free radicals.

type 2 diabetes mellitus - first-degree relatives - endothelial dysfunction - acute hyperglycemia

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