Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA.
High Blood Press Cardiovasc Prev. 2023 Mar;30(2):175-181. doi: 10.1007/s40292-023-00569-2. Epub 2023 Mar 13.
Type 2 diabetes (T2D), the fastest growing pandemic, is typically accompanied by vascular complications. A central hallmark of both T2D and vascular disease is insulin resistance which causes impaired glucose transport and vasoconstriction concomitantly. Those with cardiometabolic disease display greater variation in central hemodynamics and arterial elasticity, both potent predictors of cardiovascular morbidity and mortality, which may be exacerbated by concomitant hyperglycemia and hyperinsulinemia during glucose testing. Thus, elucidating central and arterial responses to glucose testing in those with T2D may identify acute vascular pathophysiologies triggered by oral glucose loading.
This study compared hemodynamics and arterial stiffness to an oral glucose challenge (OGC: 50g glucose) between individuals with and without T2D. 21 healthy (48 ± 10 years) and 20 participants with clinically diagnosed T2D and controlled hypertension (52 ± 8 years) were tested.
Hemodynamics and arterial compliance were assessed at baseline, and 10, 20, 30, 40, 50, and 60 min post-OGC.
Heart rate increased between 20 and 60 post-OGC in both groups (p < 0.05). Central systolic blood pressure (SBP) decreased in the T2D group between 10 and 50 min post-OGC while central diastolic blood pressure (DBP) decreased in both groups from 20 to 60 post-OGC. Central SBP decreased in T2D between 10 and 50 min post-OGC and central DBP decreased in both groups between 20 and 60 min post-OGC. Brachial SBP decreased between 10 and 50 min in healthy participants, whereas both groups displayed decreases in brachial DBP between 20 and 60 min post-OGC. Arterial stiffness was unaffected.
An OGC alters central and peripheral blood pressure in healthy and T2D participants similarly with no changes in arterial stiffness.
2 型糖尿病（T2D）是目前发展最快的大流行病，通常伴有血管并发症。T2D 和血管疾病的一个中心特征是胰岛素抵抗，这会导致葡萄糖转运和血管收缩同时受损。患有心脏代谢疾病的人表现出更大的中央血液动力学和动脉弹性变化，这两者都是心血管发病率和死亡率的有力预测指标，在葡萄糖测试期间同时存在高血糖和高胰岛素血症可能会使这些变化恶化。因此，在 T2D 患者中阐明葡萄糖测试对中央和动脉的反应可能会发现口服葡萄糖负荷引起的急性血管病理生理学变化。
本研究比较了有和没有 T2D 的个体在口服葡萄糖挑战（OGC：50g 葡萄糖）期间的血液动力学和动脉僵硬情况。共测试了 21 名健康志愿者（48 ± 10 岁）和 20 名患有临床诊断的 T2D 合并控制良好的高血压患者（52 ± 8 岁）。
在基线时以及 OGC 后 10、20、30、40、50 和 60 分钟评估血液动力学和动脉顺应性。
OGC 后 20 至 60 分钟，两组的心率均升高（p < 0.05）。T2D 组的中心收缩压（SBP）在 OGC 后 10 至 50 分钟期间下降，而两组的中心舒张压（DBP）在 OGC 后 20 至 60 分钟期间下降。T2D 组的中心 SBP 在 OGC 后 10 至 50 分钟期间下降，两组的中心 DBP 在 OGC 后 20 至 60 分钟期间下降。OGC 后 10 至 50 分钟，健康参与者的肱动脉 SBP 下降，而两组的肱动脉 DBP 在 OGC 后 20 至 60 分钟期间均下降。动脉僵硬度没有变化。
OGC 以相似的方式改变健康和 T2D 参与者的中央和外周血压，而动脉僵硬度没有变化。
