Key result
Pre-diabetic hyperglycemia was associated with a significantly higher fasting stiffness index compared to normoglycemic controls (2.19 vs 1.96, P=0.005), though this was strongly driven by age and blood pressure.
Why the study?
Does pre-diabetic hyperglycemia alter fasting and postprandial vascular function (stiffness index and reflective index) compared to normoglycemic individuals?
Cross-Sectional (n=44)
No
Does pre-diabetic hyperglycemia alter fasting and postprandial vascular function (stiffness index and reflective index) compared to normoglycemic individuals?
Absolute Event Rate: 2.19% vs 1.96%
p-value: p=0.005
Increased arterial stiffness in pre-diabetic subjects appears to be primarily driven by age and blood pressure rather than glycemic changes alone.
Pre-diabetes stiffness differences appear driven by age/BP, not glycemia alone; leaves open independent effects and need for prospective studies.
BACKGROUND: Arterial stiffness is an independent risk factor for cardiovascular disease and its progression may be accelerated in the presence of hyperglycemia, either fasting or postprandial. The current study assessed vascular function in subjects with pre-diabetes hyperglycemia, using digital volume pulse analysis technique. METHODS: We conducted a cross-sectional study examining vascular function in the fasting and postprandial (glucose-induced) state in 44 adults, consisting of 17 subjects with pre-diabetic hyperglycemia and 27 normoglycemic volunteers. Photoplethysmography of the digital volume pulse (DVP) was used to determine stiffness index (SI) and reflective index (RI), as main measures of larger artery stiffness and vascular tone, respectively. RESULTS: Our results showed a significantly higher (Ln) fasting SI in the hyperglycemic group compared with the control group (2.19 ± 0.32 vs. 1.96 ± 0.22, P = 0.005). However, this pattern reversed after adjustment for potential confounders. In multiple linear regression analysis, (Ln) SI was related to age (β = 0.01, 95% CI: 0.01-0.02, P < 0.001) and systolic blood pressure (SBP) (β = 0.01, 95% CI: 0.00-0.01, P < 0.05), but not with W/H, diastolic blood pressure (DBP), fasting plasma glucose (FPG) or serum lipids. Furthermore, age (β = 0.02, 95% CI: 0.01-0.03, P < 0.001) and mean arterial pressure (MAP) (β = 0.01, 95% CI: 0.00-0.02, P < 0.05) were found as the strong predictors of fasting SI in hyperglycemic group. Neither FPG nor 2-h plasma glucose was a significant predictor for SI in hyperglycemic group, after accounting for age and MAP. Subjects with hyperglycemia had a 15% blunted change in postprandial AUCs for RI, adjusted for the respective baseline measurements (-9.40 ± 3.59 vs. -11.00 ± 2.84%) but these did not attain statistical significance. CONCLUSION: Increased arterial stiffness in pre-diabetic subjects is strongly associated with age and MAP. The increased DVP-derived SI reported in patients with pre-diabetic hyperglycemia may result from different frequently accompanied risk factors not just glycemic changes in this range.
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Alaei-Shahmiri et al. (2015) conducted a cross-sectional in Pre-diabetic hyperglycemia (n=44). 75-g oral glucose load vs. Normoglycemic volunteers was evaluated on (Ln) Fasting stiffness index (SI) (p=0.005). Pre-diabetic hyperglycemia was associated with a significantly higher fasting stiffness index compared to normoglycemic controls (2.19 vs 1.96, P=0.005), though this was strongly driven by age and blood pressure.
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