Assessment of vascular function in complete glycaemic spectrum

ABSTRACT

Purpose: The present study was conceived to delineate the point of vascular dysfunction along the glycemic spectrum (normoglycemic individuals with no family history of diabetes, normoglycemic individuals with family history of diabetes, prediabetic individuals, and diabetic individuals).

Materials and Methods: In this cross-sectional comparative study, we enrolled 252 participants of both gender in the age group of 30–50 years. They were classified based on their family history of diabetes and glycemic status into four groups along the glycemic spectrum as mentioned above. We measured flow-mediated dilation (FMD) from brachial artery and vascular function biomarkers such as enthothelin-1 (ET-1), von Willbrand Factor (vWF), Vascular Endothelial Growth Factor (VEGF) to assess the vascular function. The comparison of data between groups were done using One Way ANOVA/Kruskal–Wallis followed by post-hoc analysis using LSD/Mann–Whitney U Test depending on the normality of the data. Spearman correlation was done between vascular function and plasma glucose levels to identify its relationship. Linear regression was carried out to identify the factors influencing the FMD across the glycemic spectrum.

Results: We observed that vascular function negatively correlated with blood glucose levels. However, endothelin-1 and vWF derangement was there even in normoglycemic first degree relatives of diabetes (FDRD) and the derangement increased in prediabetes and diabetes. Physiological dysfunction in terms of decreased flow-mediated dilation starts from prediabetes only. VEGF derangement is found only in diabetic individuals.

Conclusion: Vascular dysfunction is found even in normoglycemic FDRD and the derangement increased and compounded with the advancement of disease.

KEYWORDS:

• Diabetes
• flow-mediated dilation
• glucose prediabetes
• vascular dysfunction

Acknowledgments

The authors are thankful to all the participants who participated in the study and we thank JIPMER and Research Society for the study of Diabetes India for extending financial support.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The study was partially funded by JIPMER intramural funding and extramural funding from Research Society for the Study of Diabetes in India [RSSDI/HQ/Grants/2017/181]