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Exp Clin Endocrinol Diabetes 2010; 118(1): 57-60
DOI: 10.1055/s-0029-1233453
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Alcohol Acutely Increases Vascular Reactivity together with Insulin Sensitivity in Type 2 Diabetic Men

G. Schaller1 , S. Kretschmer2 , G. Gouya1 , D. G. Haider1 , 2 , F. Mittermayer1 , M. Riedl2 , O. Wagner3 , G. Pacini4 , M. Wolzt1 , 2 , B. Ludvik2
  • 1Department of Clinical Pharmacology, Medical University of Vienna, Austria.
  • 2Department of Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Austria.
  • 3Department of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Austria.
  • 4Metabolic Unit, Institute of Biomedical Engineering (ISIB–CNR), Padova, Italy.
Further Information

Publication History

received 08.02.2009 first decision 03.06.2009

accepted 25.06.2009

Publication Date:
15 October 2009 (online)

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Abstract

Moderate alcohol consumption is associated with increased insulin sensitivity and reduced cardiovascular risk. We hypothesized that this relates to a direct effect of alcohol and therefore investigated whether acute alcohol intake altered insulin sensitivity or endothelial function in patients with type 2 diabetes. In an open-label two period design, the effect of a single oral dose of 40 g of alcohol (168 ml 40% vodka) on an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGT) and on endothelium-dependent (flow mediated, FMD) or endothelium-independent (glyceroltrinitrate (GTN)-induced) vasodilation of the brachial artery measured by ultrasound was studied. Experiments were carried out in twelve male patients with type 2 diabetes mellitus (64±6 years, body mass index 28.4±5.7 kg/m2). Baseline insulin sensitivity index (SI) was 1.10±0.34 min−1.μU−1.ml, baseline FMD was +4.1±3.0%, and GTN-induced vasodilation +7.4±2.3% from resting brachial artery diameter. Acute alcohol intake increased alcohol plasma levels to 0.33±0.04‰, SI to 1.86±0.45 min−1.μU−1.ml (p<0.05), and FMD to +8.2±2.8% (p<0.05), while GTN-induced dilation remained unchanged. No relationship was detectable between the observed changes. We conclude that alcohol intake acutely increases endothelium-dependent brachial ar-tery vasodilation in patients with type 2 diabetes together with insulin sensitivity. This acute effect might explain some beneficial effects of low alcohol consumption in epidemiological observations.

Key words

alcohol - vascular reactivity - insulin sensitivity - type 2 diabetes

References

  • 1 Ader M, Pacini G, Yang YJ. et al . Importance of glucose per se to intravenous glucose tolerance. Comparison of the minimal-model prediction with direct measurements.  Diabetes. 1985;  34 1092-1103
    CrossrefPubMedGoogle Scholar
  • 2 Agewall S, Wright S, Doughty RN. et al . Does a glass of red wine improve endothelial function?.  Eur Heart J. 2000;  21 74-78
    CrossrefPubMedGoogle Scholar
  • 3 Ahrén B, Pacini G. Impaired adaptation of first-phase insulin secretion in postmenopausal women with glucose intolerance.  Am J Physiol. 1997;  273 E701-E707
    PubMedGoogle Scholar
  • 4 Avogaro A, Watanabe RM, Gottardo L. et al . Glucose tolerance during moderate alcohol intake: Insights on insulin action from glucose/lactate dynamics.  J Clin Endocrinol Metab. 2002;  87 1233-1238
    CrossrefPubMedGoogle Scholar
  • 5 Avogaro A, Watanabe RM, Dall’Arche A. et al . Acute alcohol consumption improves insulin action without affecting insulin secretion in type 2 diabetic subjects.  Diabetes Care. 2004;  27 1369-1374
    CrossrefPubMedGoogle Scholar
  • 6 Baron AD, Clark MG. Role of blood flow in the regulation of muscle glucose uptake.  Annu Rev Nutr. 1997;  17 487-499
    CrossrefPubMedGoogle Scholar
  • 7 Bau PF, Bau CH, Naujorks AA. et al . Early and late effects of alcohol ingestion on blood pressure and endothelial function.  Alcohol. 2005;  37 53-58
    CrossrefPubMedGoogle Scholar
  • 8 Bergman RN. Lilly lecture 1989. Toward physiological understanding of glucose tolerance. Minimal-model approach.  Diabetes. 1989;  38 1512-1527
    CrossrefPubMedGoogle Scholar
  • 9 Bloch-Damti A, Bashan N. Proposed mechanisms for the induction of insulin resistance by oxidative stress.  Antioxid Redox Signal. 2005;  7 1553-1567
    CrossrefPubMedGoogle Scholar
  • 10 Caballero AE, Arora S, Saouaf R. et al . Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes.  Diabetes. 1999;  48 1856-1862
    CrossrefPubMedGoogle Scholar
  • 11 Calles-Escandon J, Cipolla M. Diabetes and endothelial dysfunction: A clinical perspective.  Endocr Rev. 2001;  22 36-52
    CrossrefPubMedGoogle Scholar
  • 12 Cersosimo E, Defronzo RA. Insulin resistance and endothelial dysfunction: The road map to cardiovascular diseases.  Diabetes Metab Res Rev. 2006;  22 ((6)) 423-436
    CrossrefPubMedGoogle Scholar
  • 13 Diem P, Deplazes M, Fajfr R. et al . Effects of alcohol consumption on mortality in patients with type 2 diabetes mellitus.  Diabetologia. 2003;  46 1581-1585
    CrossrefPubMedGoogle Scholar
  • 14 Femia R, Natali A, L’Abbate A. et al . Coronary atherosclerosis and alcohol consumption: Angiographic and mortality data.  Arterioscler Thromb Vasc Biol. 2006;  26 1607-1612
    CrossrefPubMedGoogle Scholar
  • 15 Hashimoto M, Kim S, Eto M. et al . Effect of acute intake of red wine on flow-mediated vasodilatation of the brachial artery.  Am J Cardiol. 2001;  88 1457-1460 , A1459
    CrossrefPubMedGoogle Scholar
  • 16 Kim JA, Montagnani M, Koh KK. et al . Reciprocal relationships between insulin resistance and endothelial dysfunction: Molecular and pathophysiological mechanisms.  Circulation. 2006;  113 1888-1904
    CrossrefPubMedGoogle Scholar
  • 17 Kleinman JC, Donahue RP, Harris MI. et al . Mortality among diabetics in a national sample.  Am J Epidemiol. 1988;  128 389-401
    PubMedGoogle Scholar
  • 18 Lee IK, Kim HS, Bae JH. Endothelial dysfunction: Its relationship with acute hyperglycaemia and hyperlipidemia.  Int J Clin Pract Suppl. 2002;  ((129)) 59-64
    PubMedGoogle Scholar
  • 19 Matsuo S, Nakamura Y, Takahashi M. et al . Effect of red wine and ethanol on production of nitric oxide in healthy subjects.  Am J Cardiol. 2001;  87 1029-1031 , A1026
    CrossrefPubMedGoogle Scholar
  • 20 Napoli R, Cozzolino D, Guardasole V. et al . Red wine consumption improves insulin resistance but not endothelial function in type 2 diabetic patients.  Metabolism. 2005;  54 306-313
    CrossrefPubMedGoogle Scholar
  • 21 Okon EB, Chung AW, Rauniyar P. et al . Compromised arterial function in human type 2 diabetic patients.  Diabetes. 2005;  54 2415-2423
    CrossrefPubMedGoogle Scholar
  • 22 Pacini G, Bergman RN. Minmod: A computer program to calculate insulin sensitivity and pancreatic responsivity from the frequently sampled intravenous glucose tolerance test.  Comput Methods Programs Biomed. 1986;  23 113-122
    CrossrefPubMedGoogle Scholar
  • 23 Pinkney JH, Stehouwer CD, Coppack SW. et al . Endothelial dysfunction: Cause of the insulin resistance syndrome.  Diabetes. 1997;  46 (Suppl 2) S9-S13
    PubMedGoogle Scholar
  • 24 Reaven GM. Role of insulin resistance in human disease (syndrome x): An expanded definition.  Annu Rev Med. 1993;  44 121-131
    CrossrefPubMedGoogle Scholar
  • 25 Rimm EB, Giovannucci EL, Willett WC. et al . Prospective study of alcohol consumption and risk of coronary disease in men.  Lancet. 1991;  338 464-468
    CrossrefPubMedGoogle Scholar
  • 26 Schaller G, Kolodjaschna J, Pleiner J. et al . Pioglitazone does not affect vascular or inflammatory responses after endotoxemia in humans.  Horm Metab Res. 2008;  40 549-555
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Schmidt A, Pleiner J, Bayerle-Eder M. et al . Regular physical exercise improves endothelial function in heart transplant recipients.  Clin Transplant. 2002;  16 137-143
    CrossrefPubMedGoogle Scholar
  • 28 Schröder H, Marrugat J, Fito M. et al . Alcohol consumption is directly associated with circulating oxidized low-density lipoprotein.  Free Radic Biol Med. 2006;  40 1474-1481
    CrossrefPubMedGoogle Scholar
  • 29 Sesso HD, Stampfer MJ, Rosner B. et al . Seven-year changes in alcohol consumption and subsequent risk of cardiovascular disease in men.  Arch Intern Med. 2000;  160 2605-2612
    CrossrefPubMedGoogle Scholar
  • 30 Solomon CG, Hu FB, Stampfer MJ. et al . Moderate alcohol consumption and risk of coronary heart disease among women with type 2 diabetes mellitus.  Circulation. 2000;  102 494-499
    PubMedGoogle Scholar
  • 31 Spaak J, Merlocco AC, Soleas GJ. et al . Dose-related effects of red wine and alcohol on hemodynamics, sympathetic nerve activity, and arterial diameter.  Am J Physiol Heart Circ Physiol. 2008;  294 H605-H612
    PubMedGoogle Scholar
  • 32 Stampfer MJ, Colditz GA, Willett WC. et al . A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women.  N Engl J Med. 1988;  319 267-273
    CrossrefPubMedGoogle Scholar
  • 33 Tawakol A, Omland T, Creager MA. Direct effect of ethanol on human vascular function.  Am J Physiol Heart Circ Physiol. 2004;  286 H2468-H2473
    CrossrefPubMedGoogle Scholar
  • 34 Ueda S, Petrie JR, Cleland SJ. et al . The vasodilating effect of insulin is dependent on local glucose uptake: A double blind, placebo-controlled study.  J Clin Endocrinol Metab. 1998;  83 2126-2131
    CrossrefPubMedGoogle Scholar
  • 35 Valmadrid CT, Klein R, Moss SE. et al . Alcohol intake and the risk of coronary heart disease mortality in persons with older-onset diabetes mellitus.  JAMA. 1999;  282 239-246
    CrossrefPubMedGoogle Scholar
  • 36 Venkov CD, Myers PR, Tanner MA. et al . Ethanol increases endothelial nitric oxide production through modulation of nitric oxide synthase expression.  Thromb Haemost. 1999;  81 638-642
    PubMedGoogle Scholar
  • 37 Whelan AP, Sutherland WH, McCormick MP. et al . Effects of white and red wine on endothelial function in subjects with coronary artery disease.  Intern Med J. 2004;  34 224-228
    CrossrefPubMedGoogle Scholar

Correspondence

B. LudvikMD 

Department of Medicine III

Division of Endocrinology and Metabolism

Medical University of Vienna

Allgemeines Krankenhaus Wien

Währinger Gürtel 18–20

1090 Wien

Austria

Phone: (+43-1) 40400 4364

Fax: (+43-1) 405 93 234

Email: bernhard.ludvik@meduniwien.ac.at

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