Tutor, Department of Physiology, AIIMS, Mangalagiri, Andhra Pradesh, India.
Department of Physiology, All India Institute of Medical Sciences, Rajkot, India.
Clin Exp Hypertens. 2021 Jul 4;43(5):436-442. doi: 10.1080/10641963.2021.1896729. Epub 2021 Mar 11.
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). 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. 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. Vascular dysfunction is found even in normoglycemic FDRD and the derangement increased and compounded with the advancement of disease.
本研究旨在描绘沿血糖谱的血管功能障碍点（无糖尿病家族史的正常血糖个体、有糖尿病家族史的正常血糖个体、糖尿病前期个体和糖尿病个体）。在这项横断面比较研究中，我们招募了 252 名年龄在 30-50 岁之间的男女参与者。根据他们的糖尿病家族史和血糖状况，将他们分为上述血糖谱的四个组。我们测量了肱动脉的血流介导扩张（FMD）和血管功能生物标志物，如内皮素-1（ET-1）、血管性血友病因子（vWF）、血管内皮生长因子（VEGF），以评估血管功能。使用 One Way ANOVA/Kruskal-Wallis 对组间数据进行比较，然后根据数据的正态性使用 LSD/Mann-Whitney U 检验进行事后分析。使用 Spearman 相关性分析血管功能与血浆葡萄糖水平之间的关系。进行线性回归分析，以确定血糖谱中影响 FMD 的因素。我们观察到血管功能与血糖水平呈负相关。然而，即使在糖尿病一级亲属（FDRD）的正常血糖个体中，内皮素-1 和 vWF 也出现了紊乱，而且在糖尿病前期和糖尿病中，紊乱程度增加。仅在糖尿病前期就出现了血流介导扩张的生理功能障碍。仅在糖尿病个体中发现 VEGF 紊乱。即使在正常血糖的 FDRD 中也发现了血管功能障碍，而且随着疾病的进展，紊乱程度增加并加剧。
