Hyperglycemia increases muscle blood flow and alters endothelial function in adolescents with type 1 diabetes
Amanda S Dye, Hong Huang, John A Bauer, Robert P Hoffman, Amanda S Dye, Hong Huang, John A Bauer, Robert P Hoffman
Abstract
Alterations of blood flow and endothelial function precede development of complications in type 1 diabetes. The effects of hyperglycemia on vascular function in early type 1 diabetes are poorly understood. To investigate the effect of hyperglycemia on forearm vascular resistance (FVR) and endothelial function in adolescents with type 1 diabetes, FVR was measured before and after 5 minutes of upper arm arterial occlusion using venous occlusion plethysmography in (1) fasted state, (2) euglycemic state (~90 mg/dL; using 40 mU/m(2)/min insulin infusion), and (3) hyperglycemic state (~200 mg/dL) in 11 adolescents with type 1 diabetes. Endothelial function was assessed by the change in FVR following occlusion. Seven subjects returned for a repeat study with hyperglycemia replaced by euglycemia. Preocclusion FVR decreased from euglycemia to hyperglycemia (P = 0.003). Postocclusion fall in FVR during hyperglycemia was less than during euglycemia (P = 0.002). These findings were not reproduced when hyperglycemia was replaced with a second euglycemia. These results demonstrate that acute hyperglycemia causes vasodilation and alters endothelial function in adolescents with type 1 diabetes. In addition they have implications for future studies of endothelial function in type 1 diabetes and provide insight into the etiology of macrovascular and microvascular complications of type 1 diabetes.
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References
- McGill HC, Jr., McMahan CA, Herderick EE, Malcom GT, Tracy RE, Jack P. Origin of atherosclerosis in childhood and adolescence. American Journal of Clinical Nutrition. 2000;72(5):1307S–1315S.
- Stehouwer CDA, Lambert J, Donker AJM, van Hinsbergh VWM. Endothelial dysfunction and pathogenesis of diabetic angiopathy. Cardiovascular Research. 1997;34(1):55–68.
- Berenson GS. Childhood risk factors predict adult risk associated with subclinical cardiovascular disease: the Bogalusa Heart study. American Journal of Cardiology. 2002;90(10):3L–7L.
- Donaghue KC, Robinson J, McCredie R, Fung A, Silink M, Celermajer DS. Large vessel dysfunction in diabetic adolescents and its relationship to small vessel complications. Journal of Pediatric Endocrinology and Metabolism. 1997;10(6):593–598.
- Wiltshire EJ, Gent R, Hirte C, Pena A, Thomas DW, Couper JJ. Endothelial dysfunction relates to folate status in children and adolescents with type 1 diabetes. Diabetes. 2002;51(7):2282–2286.
- Cai H, Harrison DG. Endothelial dysfunction in cardiovascular diseases: the role of oxidant stress. Circulation Research. 2000;87(10):840–844.
- Landmesser U, Hornig B, Drexler H. Endothelial function: a critical determinant in atherosclerosis? Circulation. 2004;109(21):II27–II33.
- Jin SM, Noh CI, Yang SW, et al. Endothelial dysfunction and microvascular complications in type 1 diabetes mellitus. Journal of Korean Medical Science. 2008;23(1):77–82.
- Pennathur S, Heinecke JW. Oxidative stress and endothelial dysfunction in vascular disease. Current Diabetes Reports. 2007;7(4):257–264.
- Schalkwijk CG, Stehouwer CDA. Vascular complications in diabetes mellitus: the role of endothelial dysfunction. Clinical Science. 2005;109(2):143–159.
- Newkumet KM, Goble MM, Young RB, Kaplowitz PB, Schieken RM. Altered blood pressure reactivity in adolescent diabetics. Pediatrics. 1994;93(4):616–621.
- Järvisalo MJ, Raitakari M, Toikka JO, et al. Endothelial dysfunction and increased arterial intima-media thickness in children with type 1 diabetes. Circulation. 2004;109(14):1750–1755.
- Hoffman RP, Hausberg M, Sinkey CA, Anderson EA. Hyperglycemia without hyperinsulinemia produces both sympathetic neural activation and vasodilation in normal humans. Journal of Diabetes and its Complications. 1999;13(1):17–22.
- Kawano H, Motoyama T, Hirashima O, et al. Hyperglycemia rapidly suppresses flow-mediated endothelium-dependent vasodilation of brachial artery. Journal of the American College of Cardiology. 1999;34(1):146–154.
- Ceriello A, Piconi L, Esposito K, Giugliano D. Telmisartan shows an equivalent effect of vitamin C in further improving endothelial dysfunction after glycemia normalization in type 1 diabetes. Diabetes Care. 2007;30(7):1694–1698.
- Higashi Y, Yoshizumi M. New methods of evaluate endothelial function: method for assessing endothelial function in humans using a strain-gauge plethysmography: nitric oxide-dependent and -independent vasodilation. Journal of Pharmacological Sciences. 2003;93(4):399–404.
- Anderson EA, Hoffman RP, Balon TW, Sinkey CA, Mark AL. Hyperinsulinemia produces both sympathetic neural activation and vasodilation in normal humans. Journal of Clinical Investigation. 1991;87(6):2246–2252.
- Mogensen CE, Christensen CK, Vittinghus E. The stages in diabetic renal disease. With emphasis on the stage of incipient diabetic nephropathy. Diabetes. 1983;32(supplement 2):64–78.
- Chittari MV, Mcternan P, Bawazeer N, et al. Impact of acute hyperglycaemia on endothelial function and retinal vascular reactivity in patients with type2 diabetes. Diabetic Medicine. 2011;28(4):450–454.
- Grunwald JE, Riva CE, Petrig BL, et al. Strict control of glycaemia: effects on blood flow in the large retinal vessels and in the macular microcirculation. British Journal of Ophthalmology. 1995;79(8):735–741.
- Brouwers O, Niessen PM, Haenen G, et al. Hyperglycaemia-induced impairment of endothelium-dependent vasorelaxation in rat mesenteric arteries is mediated by intracellular methylglyoxal levels in a pathway dependent on oxidative stress. Diabetologia. 2010;53(5):989–1000.
Source: PubMed