Abstract
BackgroundHyperglycaemic load has been shown to cause endothelial dysfunction in patients diagnosed with diabetes mellitus or the pre-diabetic state of glucose intolerance. In the non-disease state such as in healthy subjects, the effect of glucose loading is still uncertain with conflicting results. The aim of this study was to test the hypothesis that an oral 75 g glucose load will not adversely attenuate the endothelial function of healthy participants, 2 hours postprandial.MethodsThis is a prospective single arm study evaluating the brachial artery flow-mediated vasodilation of 12 healthy participants before and after a 75 g glucose loading. Participants’ age, body mass index, family history of diabetes, fasting blood glucose and 2 hour postprandial glucose levels were recorded. All data were analysed with SPSS 17.0 using Wilcoxon test.ResultsPrimary analysis of the participants’ brachial artery flow mediated vasodilation before and 2 hours after 75 g oral glucose loading did not show any statistically significant attenuation (p > 0.05) in brachial artery flow-mediated vasodilation, although a trend for reduction in endothelial relaxation was observed. Subgroup analysis of healthy participants with a positive family history of diabetes confirmed a statistically significant attenuation (p < 0.05) in brachial artery flow-mediated vasodilation after acute glucose loading even though the 2 hour postprandial blood glucose level, with a median value of 4.6 ± 2.2 mmol/L was within normal limits. This was not observed in the group without a positive family history of diabetes.ConclusionAcute oral glucose loading significantly attenuates endothelial relaxation in healthy subjects with positive family history of diabetes but showed no effect in those without a positive family history of diabetes. The attenuation in endothelial relaxation was observed in the presence of normal glucose metabolism, suggesting a defect in endothelium relaxation even in the non-disease state in the group predisposed to diabetes.
Highlights
Hyperglycaemic load has been shown to cause endothelial dysfunction in patients diagnosed with diabetes mellitus or the pre-diabetic state of glucose intolerance
The purpose of this study was to test the hypothesis that transient acute glucose loading, induced by a 75 g oral glucose loading does not attenuate endothelial function in healthy individuals. This is a prospective single arm study assessing the effect of a 75 g oral glucose load on vascular endothelial function as measured by brachial artery flow-mediated vasodilation [Brachial artery flow mediated dilation (BAFMD)]), in healthy individuals recruited from the Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital and from Universiti Brunei Darussalam (UBD)
The difference between this study and earlier studies that do show attenuation in endothelial function after a glucose load may be due to differences in the method of glucose delivery [12,20,21]
Summary
Hyperglycaemic load has been shown to cause endothelial dysfunction in patients diagnosed with diabetes mellitus or the pre-diabetic state of glucose intolerance. Postprandial hyperglycaemia, which is an independent risk factor for cardiovascular disease, is accompanied by endothelial dysfunction [4,5]. It has been shown that due to chronic hyperglycaemia, there is endothelial Endothelial dysfunction in these groups of individuals is already well established by the time they present for medical attention. Such endothelial dysfunction does not occur suddenly but is a process that gradually develops over time and may already be present even when the individual was healthy and disease free. The effect of glucose load on the endothelial function in healthy individuals has previously been studied but the available data have been conflicting. Some studies have suggested that a hyperglycaemic load attenuates endothelial function while more recent studies reported an absence of attenuation of endothelium function [9,10,11,12,13,14,15,16]
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