Effects of typical Western meal on postprandial arterial stiffness and vasoactive chemicals in patients with chronic kidney disease and Type II Diabetes

Abstract

The purpose was to evaluate the effect of an 800 kcal meal (carbohydrate:fat:protein = 41:46:13) on postprandial arterial stiffness in patients with CKD and Type II Diabetes (CKD&T2DM) (n=7). Comparisons were made to patients with T2DM only (n=7) and healthy controls (CON) (n=8).MethodsUnder fasting conditions, arterial stiffness was measured, then an indwelling catheter was inserted and a blood sample was collected. Stiffness was measured/blood collected immediately after the meal and every hour (h) for 4h. Augmentation index normalized to 75 heart beats per minute (Aix75) was used to estimate arterial stiffness.ResultsAix75: Decreased from baseline (bl) (17.3 ± 2.5) to 1h (9.3 ± 2.3) returned at h4 p < .05 (pooled time effect). CKD&T2DM and T2DM differed from the CON (26.7 ± 4.1; 17.7± 9.7 vs. −3.65 ± 3.6) p < .05 but not each other (pooled group effect). SBP: CKD&T2DM (131.5 ± 4.8) differed from the CON (114.5 + 3.4) p < .05. The CON and T2DM (121.8 ± 3.7) did not differ, nor did CKD&T2DM and T2DM. DBP: Decreased from bl (74.8 ± 2.2) in h1 and 2 (67.5 ± 2.5; 68.0 ± 2.5) and returned at h4 (73.0 + 2.4) p < .05 in all groups. Nitric oxide: No time or group effect. Endothelin: Was lower in all groups at h3 than at h0, h1, and 2 p < .05.DiscussionCKD&T2DM and T2DM patients experience a smaller postprandial reduction in arterial stiffness when compared to healthy CON. Hemodyamics may be a main contributor as illustrated by the trend seen in DBP.