Korean Diabetes J.  2010 Oct;34(5):287-293. 10.4093/kdj.2010.34.5.287.

The Association of Brachial-Ankle Pulse Wave Velocity with 30-Minute Post-Challenge Plasma Glucose Levels in Korean Adults with No History of Type 2 Diabetes

• Choi ES
• Rhee EJ
• Choi JH
• Bae JC
• Yoo SH
• Kim WJ
• Park SE
• Park CY
• Lee WY
• Cho YK
• Oh KW
• Park SW
• Kim SW

• KMID: 2029886
• DOI: http://doi.org/10.4093/kdj.2010.34.5.287

Abstract

BACKGROUND
Acute postprandial hyperglycemia is an important affector for atherosclerosis in subjects with glucose intolerance. We analyzed the relationship of brachial-ankle pulse wave velocity (baPWV) with fasting and post-challenge plasma glucose levels according to different time points during oral glucose tolerance test (OGTT).
METHODS
In 663 subjects with fasting hyperglycemia, 75 g OGTT were performed to confirm the glucose tolerant status, and fasting, post-challenge 30-minute and 120-minute glucose levels were measured. Anthropometric measurements were done, and fasting lipid profiles were measured. baPWV were measured in all subjects and the relationship between fasting, 30- and 120-minute post-challenge glucose levels and baPWV were analyzed.
RESULTS
Among the participants, 62.9% were prediabetes and 31.7% were diabetes. Mean baPWV value was significantly higher in subjects with diabetes compared with prediabetes group. In bivariate correlation analyses, age, blood pressure, total cholesterol, low density lipoprotein cholesterol, 30-minute and 120-minute post-challenge glucose levels showed significant positive correlation with baPWV value. In multiple regression analysis, 30-minute post-challenge glucose level was a weak but significant determinant for mean baPWV value even after adjustment for other confounding variables.
CONCLUSIONS
Postprandial hyperglycemia, especially 30-minute glucose levels showed significant correlation with baPWV in subjects with fasting hyperglycemia. These results can imply the deleterious effect of acute hyperglycemic excursion on arterial stiffness in subjects with glucose intolerance.

Keyword

Arterial stiffness; Oral glucose tolerance test; Postprandial hyperglycemia; Pulse wave analysis

MeSH Terms

Adult
Atherosclerosis
Blood Pressure
Cholesterol
Cholesterol, LDL
Confounding Factors (Epidemiology)
Fasting
Glucose
Glucose Intolerance
Glucose Tolerance Test
Humans
Hyperglycemia
Lipoproteins
Plasma
Prediabetic State
Pulse Wave Analysis
Vascular Stiffness
Cholesterol
Cholesterol, LDL
Glucose
Lipoproteins

Reference

1. Abdul-Ghani MA, Abdul-Ghani T, Ali N, Defronzo RA. One-hour plasma glucose concentration and the metabolic syndrome identify subjects at high risk for future type 2 diabetes. Diabetes Care. 2008. 31:1650–1655.

2. Ratner R, Goldberg R, Haffner S, Marcovina S, Orchard T, Fowler S, Temprosa M. Diabetes Prevention Program Research Group. Impact of intensive lifestyle and metformin therapy on cardiovascular disease risk factors in the diabetes prevention program. Diabetes Care. 2005. 28:888–894.

3. Succurro E, Marini MA, Arturi F, Grembiale A, Lugara M, Andreozzi F, Sciacqua A, Lauro R, Hribal ML, Perticone F, Sesti G. Elevated one-hour post-load plasma glucose levels identifies subjects with normal glucose tolerance but early carotid atherosclerosis. Atherosclerosis. 2009. 207:245–249.

4. Cameron JD, Cruickshank JK. Glucose, insulin, diabetes and mechanisms of arterial dysfunction. Clin Exp Pharmacol Physiol. 2007. 34:677–682.

5. Gordin D, Ronnback M, Forsblom C, Heikkila O, Saraheimo M, Groop PH. Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes. Diabetologia. 2007. 50:1808–1814.

6. Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, Yamamoto Y, Hori S. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res. 2003. 26:615–622.

7. Kasayama S, Saito H, Mukai M, Koga M. Insulin sensitivity independently influences brachial-ankle pulse-wave velocity in non-diabetic subjects. Diabet Med. 2005. 22:1701–1706.

8. Yufu K, Takahashi N, Hara M, Saikawa T, Yoshimatsu H. Measurement of the brachial-ankle pulse wave velocity and flow-mediated dilatation in young, healthy smokers. Hypertens Res. 2007. 30:607–612.

9. Djaberi R, Beishuizen ED, Pereira AM, Rabelink TJ, Smit JW, Tamsma JT, Huisman MV, Jukema JW. Non-invasive cardiac imaging techniques and vascular tools for the assessment of cardiovascular disease in type 2 diabetes mellitus. Diabetologia. 2008. 51:1581–1593.

10. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care. 1999. 22:233–240.

11. Henry RM, Kostense PJ, Spijkerman AM, Dekker JM, Nijpels G, Heine RJ, Kamp O, Westerhof N, Bouter LM, Stehouwer CD. Hoorn Study. Arterial stiffness increases with deteriorating glucose tolerance status: the Hoorn Study. Circulation. 2003. 107:2089–2095.

12. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation. 2002. 106:2085–2090.

13. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009. 32:Suppl 1. S62–S67.

14. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH publication no. 04-5230. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. 2004. Bethesda: National Institutes of Health.

15. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985. 28:412–419.

16. List of NGSP certified methods. NGSP. accessed 2010 Oct 6. Available from: http://www.ngsp.org/docs/methods.pdf.

17. Kubo T, Miyata M, Minagoe S, Setoyama S, Maruyama I, Tei C. A simple oscillometric technique for determining new indices of arterial distensibility. Hypertens Res. 2002. 25:351–358.

18. Oliver JJ, Webb DJ. Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. Arterioscler Thromb Vasc Biol. 2003. 23:554–566.

19. Weber T, Auer J, O'Rourke MF, Kvas E, Lassnig E, Berent R, Eber B. Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation. 2004. 109:184–189.

20. Schram MT, Henry RM, van Dijk RA, Kostense PJ, Dekker JM, Nijpels G, Heine RJ, Bouter LM, Westerhof N, Stehouwer CD. Increased central artery stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn Study. Hypertension. 2004. 43:176–181.

21. Fukui M, Kitagawa Y, Nakamura N, Mogami S, Ohnishi M, Hirata C, Ichio N, Wada K, Kamiuchi K, Shigeta M, Sawada M, Hasegawa G, Yoshikawa T. Augmentation of central arterial pressure as a marker of atherosclerosis in patients with type 2 diabetes. Diabetes Res Clin Pract. 2003. 59:153–161.

22. Node K, Inoue T. Postprandial hyperglycemia as an etiological factor in vascular failure. Cardiovasc Diabetol. 2009. 8:23.

23. Caumo A, Luzi L. First-phase insulin secretion: does it exist in real life? Considerations on shape and function. Am J Physiol Endocrinol Metab. 2004. 287:E371–E385.

24. DECODE Study Group, the European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med. 2001. 161:397–405.