Abstract 15421: Central Hemodynamic Response to Oral Glucose Loading Are Blunted in Patients with Impaired Glucose Tolerance or Diabetes

Abstract

Introduction: Impaired glucose tolerance (IGT) as well as diabetes is associated with the development of cardiovascular disease. We tested the hypothesis that central hemodynamic responses to oral glucose loading were different according to the status of glucose tolerance. Methods: This study enrolled 89 patients with known or suspected coronary artery disease who underwent 75g oral glucose tolerance test (OGTT). Augmentation index (AIx) and central systolic blood pressure (cSBP) were measured using radial applanation tonometry (Omron, HEM 9000-AI) at fasting, and 1, 2 hours after oral glucose loading. Results: In overall patients, oral glucose loading increased pulse rate (60.0 ± 10.4 to 64.7 ± 11.9 bpm, p<0.001), and decreased AIx normalized to a heart rate of 75 bpm (AIx@75) (81.6 ± 13.9 to 74.5 ± 14.1 %, p<0.001) and cSBP (114.7 ± 22.2 to 108.6 ± 21.3 mmHg, p<0.001) at 2h. OGTT identified normal glucose tolerance (NGT) in 40 patients, IGT in 36 patients and diabetes in 13 patients. Decrease in AIx@75 during OGTT was blunted in IGT as well as diabetes patients compared to NGT patients. Decrease in cSBP during OGTT was blunted in IGT patients than NGT patients, and no significant decrease was found in diabetes patients. Conclusions: Our data suggested that central hemodynamic responses to oral glucose loading were blunted in patients with impaired glucose tolerance or diabetes. This blunted fluctuation might be associated with adverse outcome in patients with IGT or diabetes through persistently high levels of AIx and cSBP.